Differential Diagnosis for Hematuria and Lower Abdominal Pain
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is often the most common cause of hematuria and lower abdominal pain, especially in women. The presence of bacteria in the urine, dysuria, and frequent urination support this diagnosis.
Other Likely Diagnoses
- Kidney Stones: Painful urination, severe abdominal or flank pain, and the presence of blood in the urine are characteristic of kidney stones. The pain can radiate to the lower abdomen.
- Bladder Stones: Similar to kidney stones but with a focus on bladder symptoms, such as difficulty urinating and pain in the lower abdomen.
- Prostatitis: In men, inflammation of the prostate can cause lower abdominal pain, difficulty urinating, and hematuria.
Do Not Miss Diagnoses
- Testicular Torsion: Although more commonly associated with severe testicular pain, it can sometimes present with lower abdominal pain and, in rare cases, hematuria if there's associated urinary tract involvement. It's a surgical emergency.
- Ectopic Pregnancy: In women of childbearing age, this is a critical diagnosis to consider, especially if there's a history of missed periods or positive pregnancy test. It can present with lower abdominal pain and, occasionally, hematuria.
- Appendicitis: While primarily causing right lower quadrant pain, appendicitis can sometimes present with more generalized or lower abdominal pain and, in rare instances, hematuria if the appendix is near the urinary tract.
Rare Diagnoses
- Bladder Cancer: More common in older adults, especially those with a history of smoking. It can present with painless hematuria but sometimes is accompanied by lower abdominal pain.
- Kidney Cancer: Similar to bladder cancer, it's more common in older adults and can cause hematuria and abdominal pain, though the pain is often more flank-like.
- Sickle Cell Disease: In patients with sickle cell disease, sickling crises can cause a variety of symptoms including abdominal pain and, occasionally, hematuria due to sickling in the kidneys.
- Henoch-Schönlein Purpura (HSP): A form of vasculitis that can cause abdominal pain, hematuria, and a characteristic rash. It's more common in children but can occur in adults.