Differential Diagnosis for Early Ejaculation, Problems with Erection, and Chronic Non-Bacterial Prostatitis

Single Most Likely Diagnosis

• Chronic Pelvic Pain Syndrome (CPPS): This condition is characterized by chronic pain in the pelvic region, often accompanied by symptoms such as early ejaculation and erectile dysfunction. The presence of chronic non-bacterial prostatitis, which is a type of CPPS, makes this diagnosis highly plausible.

Other Likely Diagnoses

• Performance Anxiety: Psychological factors, including anxiety about sexual performance, can lead to early ejaculation and erectile dysfunction. The chronic stress of dealing with prostatitis could exacerbate these issues.
• Neurogenic Causes: Conditions affecting the nerves, such as neuropathy or multiple sclerosis, can lead to sexual dysfunction, including problems with ejaculation and erections.
• Hormonal Imbalance: Hormonal issues, particularly low testosterone levels, can contribute to erectile dysfunction and potentially affect ejaculation timing.

Do Not Miss Diagnoses

• Prostate Cancer: Although less likely, prostate cancer can cause chronic pelvic pain, urinary symptoms, and potentially affect sexual function. Given the potential severity of this condition, it's crucial not to miss it.
• Neurological Disorders (e.g., Parkinson's Disease): Certain neurological conditions can lead to sexual dysfunction among other symptoms. Early diagnosis is critical for managing these conditions effectively.
• Vascular Diseases: Conditions like atherosclerosis can lead to erectile dysfunction due to impaired blood flow. These diseases can have serious consequences if not addressed.

Rare Diagnoses

• Peyronie's Disease: A condition characterized by the development of scar tissue inside the penis, leading to curved, painful erections. It could potentially contribute to the symptoms described, especially erectile dysfunction.
• Multiple System Atrophy: A rare neurological disorder that can affect various systems in the body, including those responsible for sexual function, leading to erectile dysfunction and potentially other sexual issues.
• Sjögren's Syndrome: An autoimmune disorder that can cause inflammation in various parts of the body, including the glands that produce fluids which might indirectly affect sexual function, though this is less common.