Differential Diagnosis for Pelvic Pressure and Sensitivity

The patient's symptoms of pelvic pressure and sensitivity, along with difficulty urinating, can be attributed to various conditions. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Urinary Tract Infection (UTI): Given the symptoms of pelvic pressure, sensitivity, and difficulty urinating, a UTI is a highly plausible diagnosis. The symptoms have been present for about 3 weeks, which could indicate a more chronic or unresolved infection.

• Other Likely Diagnoses

  • Cystitis: Inflammation of the bladder, which could be due to infection or other causes, leading to symptoms of pelvic pressure and urinary difficulties.
  • Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause pelvic pain, sensitivity, and urinary symptoms.
  • Ovarian Cyst: A cyst on the ovary can cause pelvic pressure and sensitivity, especially if it ruptures or twists, potentially leading to urinary symptoms due to pressure on the bladder or ureters.

• Do Not Miss Diagnoses

  • Ectopic Pregnancy: Although less likely if the patient is not pregnant, an ectopic pregnancy can present with pelvic pain and pressure, and is a medical emergency.
  • Appendicitis: Inflammation of the appendix can cause pelvic pain and pressure, and if ruptured, can lead to severe complications.
  • Kidney Stone: A stone in the urinary tract can cause severe pain, difficulty urinating, and pelvic pressure, especially if it obstructs the flow of urine.

• Rare Diagnoses

  • Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pelvic pain and pressure, though it might not directly cause difficulty urinating unless there's significant involvement of the urinary tract.
  • Urethral Diverticulum: An outpouching of the urethra that can cause urinary symptoms and pelvic pressure, though it's less common.
  • Pelvic Congestion Syndrome: A condition characterized by chronic pelvic pain associated with ovarian varices, which might cause pelvic pressure and sensitivity, though it's a less common diagnosis.