Differential Diagnosis for Dysuria

Dysuria, or painful urination, can be caused by various conditions. Here's a categorized differential diagnosis:

• Single most likely diagnosis
  • Urinary Tract Infection (UTI): This is the most common cause of dysuria, especially in women. Bacterial infections, such as E. coli, are often the culprit, leading to symptoms like burning sensation while urinating, frequent urination, and abdominal pain.
• Other Likely diagnoses
  • Sexually Transmitted Infections (STIs): Chlamydia, gonorrhea, and herpes can cause dysuria, especially in sexually active individuals. These infections often present with additional symptoms like discharge, itching, or genital lesions.
  • Urethral syndrome: This condition is characterized by recurring episodes of dysuria, often without evidence of infection. It may be related to factors like urethral irritation, pelvic floor dysfunction, or hormonal changes.
  • Kidney stones: Small stones in the urinary tract can cause severe pain, including dysuria, as they move through the system.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
  • Pyelonephritis: An upper urinary tract infection that can lead to sepsis if left untreated. It's essential to consider this diagnosis, especially in patients with underlying medical conditions or compromised immune systems.
  • Appendicitis: Although less common, appendicitis can present with dysuria, especially if the appendix is located near the urinary tract. Missing this diagnosis can lead to severe consequences, including perforation and peritonitis.
  • Tuberculosis (TB) of the urinary tract: TB can infect the kidneys or bladder, causing dysuria, among other symptoms. This diagnosis is crucial to consider, especially in patients with a history of TB exposure or immunocompromised individuals.
• Rare diagnoses
  • Interstitial cystitis: A chronic condition characterized by bladder pain, pressure, and sometimes dysuria. It's often diagnosed after excluding other conditions.
  • Bladder cancer: Although rare, bladder cancer can cause dysuria, especially in older adults or those with a history of smoking.
  • Sjögren's syndrome: An autoimmune disorder that can affect the bladder, leading to dysuria and other urinary symptoms.