Differential Diagnosis for a 35-year-old Female with Pelvic Floor Symptoms
Single Most Likely Diagnosis
- Pelvic Floor Dysfunction: Given the patient's history of multiple childbirths, including a 3rd-degree tear and episiotomy, it is likely that she has developed pelvic floor dysfunction. This condition can cause painful urination, urinary retention, painful sex, and general pelvic floor pain due to weakened or damaged pelvic floor muscles.
Other Likely Diagnoses
- Vulvodynia: A condition characterized by chronic pain in the vulva, which could be contributing to the patient's painful sex and pelvic floor pain.
- Interstitial Cystitis: A condition that causes bladder pressure, bladder pain, and sometimes pelvic pain, which could be contributing to the patient's painful urination and urinary retention.
- Levator Ani Syndrome: A condition characterized by chronic pain in the levator ani muscle, which could be contributing to the patient's pelvic floor pain.
Do Not Miss Diagnoses
- Pelvic Organ Prolapse: Although less likely, a pelvic organ prolapse could be causing the patient's symptoms, and if left untreated, could lead to further complications.
- Urinary Tract Infection or Kidney Stones: Infections or stones could be causing the patient's painful urination and urinary retention, and if left untreated, could lead to more serious complications such as sepsis or kidney damage.
- Endometriosis: A condition in which tissue similar to the lining of the uterus grows outside the uterus, leading to chronic pain and other symptoms. If left untreated, endometriosis can lead to infertility and other complications.
Rare Diagnoses
- Pudendal Neuralgia: A rare condition characterized by chronic pain in the pudendal nerve, which could be contributing to the patient's pelvic floor pain.
- Tarlov Cyst: A rare condition in which a cyst forms on the nerve roots in the spine, leading to chronic pain and other symptoms.
- Sacroiliitis: Inflammation of the sacroiliac joint, which could be contributing to the patient's pelvic floor pain.