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. UTIs can cause inflammation and irritation of the bladder and urinary tract, leading to blood in the urine and pain.

Other Likely Diagnoses

• Kidney Stones: Stones in the urinary tract can cause severe pain and bleeding. The pain often starts in the flank and radiates to the groin.
• Bladder Stones: Similar to kidney stones, bladder stones can cause bleeding and pain, especially during urination.
• Prostatitis: In men, inflammation of the prostate gland can cause lower abdominal pain, difficulty urinating, and hematuria.

Do Not Miss Diagnoses

• Testicular Torsion: Although more commonly associated with severe testicular pain, testicular torsion can sometimes present with lower abdominal pain and hematuria if the torsion affects the spermatic cord and surrounding structures.
• Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause lower abdominal pain and, if ruptured, can lead to hematuria due to internal bleeding.
• Appendicitis: While appendicitis typically presents with right lower quadrant pain, it can sometimes cause lower abdominal pain and, if the appendix ruptures, can lead to hematuria due to irritation of the urinary tract.

Rare Diagnoses

• Bladder Cancer: Although rare, bladder cancer can cause painless hematuria but may also be associated with lower abdominal pain in advanced stages.
• Kidney Cancer: Similar to bladder cancer, kidney cancer can cause hematuria and, if large enough, may cause lower abdominal pain.
• Sickle Cell Disease: In patients with sickle cell disease, sickling crises can cause kidney damage leading to hematuria and pain.
• Alport Syndrome: A genetic disorder affecting the type IV collagen in the body, leading to kidney disease, hearing loss, and eye abnormalities, and can cause hematuria.