Differential Diagnosis for Dysuria at End of Day

• Single most likely diagnosis
  • Overactive bladder: This condition is characterized by a sudden, intense urge to urinate, which may be exacerbated by fluid intake throughout the day, leading to dysuria that worsens by the end of the day.
• Other Likely diagnoses
  • Urinary tract infection (UTI): Although UTIs can cause dysuria at any time, some individuals may experience worsening symptoms as the day progresses due to increased fluid intake or activity.
  • Interstitial cystitis: This chronic condition causes bladder pressure, bladder pain, and sometimes pelvic pain, which may worsen throughout the day, especially if the individual is physically active or consumes certain foods or drinks.
  • Benign prostatic hyperplasia (BPH): In men, an enlarged prostate can cause urinary frequency, urgency, and dysuria, which may be more noticeable at the end of the day due to increased fluid intake.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Kidney stones: Although kidney stones can cause severe pain at any time, some individuals may experience worsening dysuria as the day progresses, especially if the stone is moving down the ureter.
  • Bladder cancer: Hemorrhagic cystitis or bladder cancer can cause dysuria, and it is essential to rule out these conditions, especially in individuals with risk factors such as smoking or exposure to certain chemicals.
• Rare diagnoses
  • Sarcoidosis: This autoimmune disease can cause bladder symptoms, including dysuria, although it is a rare cause of urinary symptoms.
  • Tuberculosis (TB) of the urinary tract: TB can infect the kidneys or bladder, causing dysuria, frequency, and other urinary symptoms, although it is a rare condition in many parts of the world.