Differential Diagnosis for Dysuria and Suprapubic Discomfort in Women (Besides UTI Causes)

Single Most Likely Diagnosis

• Vulvovaginal Candidiasis: This condition is a common cause of dysuria and suprapubic discomfort in women, especially those with risk factors such as antibiotic use, diabetes, or immunosuppression. The symptoms can mimic those of a urinary tract infection but are typically accompanied by vaginal discharge and itching.

Other Likely Diagnoses

• Vulvovaginitis: Inflammation of the vulva and vagina can cause dysuria, suprapubic discomfort, and vaginal discharge. This can be due to various causes, including bacterial vaginosis, trichomoniasis, or atrophic vaginitis.
• Interstitial Cystitis: A condition characterized by chronic inflammation of the bladder, leading to symptoms such as dysuria, frequency, urgency, and suprapubic pain. It's more common in women and can be mistaken for a UTI.
• Endometriosis: Although primarily known for causing pelvic pain and dysmenorrhea, endometriosis can also lead to dysuria and suprapubic discomfort, especially if there is bladder involvement.

Do Not Miss Diagnoses

• Ovarian Torsion: A medical emergency that can cause severe pelvic pain, which may radiate to the suprapubic area, and can be accompanied by nausea, vomiting, and sometimes dysuria due to the proximity of the ovaries to the bladder.
• Ectopic Pregnancy: Another medical emergency that can present with pelvic pain, which may be referred to the suprapubic area, and can be associated with dysuria. It's crucial to consider this diagnosis in women of childbearing age.
• Appendicitis: Although more commonly associated with right lower quadrant pain, appendicitis can sometimes present with suprapubic discomfort or dysuria if the appendix is located near the bladder or ureter.

Rare Diagnoses

• Bladder Cancer: While rare, bladder cancer can cause dysuria and suprapubic discomfort. It's more common in older adults and those with a history of smoking.
• Schistosomiasis: A parasitic infection that can cause bladder symptoms, including dysuria and suprapubic pain, especially in individuals who have traveled to or lived in endemic areas.
• Tuberculosis of the Genitourinary Tract: A rare condition that can cause chronic symptoms such as dysuria, frequency, and suprapubic pain, often accompanied by systemic symptoms like weight loss and fever.