Differential Diagnosis for Male with Low Abdominal Pain and Urinary Frequency
Single Most Likely Diagnosis
- Interstitial Cystitis: This condition is characterized by chronic inflammation of the bladder wall, leading to symptoms such as urinary frequency, urgency, and pelvic pain. The presence of bladder wall thickening on CT and the lack of response to antibiotics support this diagnosis.
Other Likely Diagnoses
- Chronic Prostatitis: This condition can cause similar symptoms, including low abdominal pain and urinary frequency. Although the UA is negative, chronic prostatitis can be difficult to diagnose and may not always show evidence of infection.
- Bladder Outlet Obstruction: This condition, which can be caused by benign prostatic hyperplasia (BPH) or other factors, can lead to urinary frequency, urgency, and pain. The bladder wall thickening on CT may be a result of chronic obstruction.
- Overactive Bladder: This condition is characterized by urinary urgency, frequency, and incontinence. Although it is often diagnosed based on symptoms, the presence of bladder wall thickening on CT may suggest an underlying cause.
Do Not Miss Diagnoses
- Bladder Cancer: Although less likely, bladder cancer is a potentially life-threatening condition that must be ruled out. The presence of bladder wall thickening on CT is a concerning finding that warrants further investigation, such as cystoscopy and biopsy.
- Invasive Infectious Disease (e.g. Tuberculosis): Although the UA is negative, certain infectious diseases such as tuberculosis can cause chronic inflammation and bladder wall thickening. These conditions can be difficult to diagnose and require specific testing.
Rare Diagnoses
- Eosinophilic Cystitis: This is a rare condition characterized by eosinophilic infiltration of the bladder wall, leading to symptoms such as urinary frequency and pain.
- Bladder Sarcoidosis: This is a rare condition in which sarcoidosis affects the bladder, leading to symptoms such as urinary frequency and pain.
- Bladder Endometriosis: This is a rare condition in which endometrial tissue grows in the bladder, leading to symptoms such as urinary frequency and pain.