Differential Diagnosis for Severe Burning Micturation in Women
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of dysuria (painful urination) in women, often accompanied by other symptoms such as frequent urination, urgency, and suprapubic discomfort. The burning sensation during micturation is a hallmark symptom.
Other Likely Diagnoses
- Vaginal Yeast Infection: Can cause irritation and burning, especially during urination if the infection is severe or if there is significant vulvar involvement.
- Bacterial Vaginosis: Though less commonly associated with dysuria, it can cause vaginal discharge and irritation that might lead to discomfort during urination.
- Trichomoniasis: A sexually transmitted infection that can cause vaginitis, leading to symptoms including dysuria.
- Urethral Syndrome: A condition where women experience symptoms of a UTI but have negative urine cultures, possibly due to urethral irritation or other non-infectious causes.
Do Not Miss Diagnoses
- Kidney Stones: While less common, kidney stones can cause severe pain and burning during urination, especially if they are obstructing the flow of urine.
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can be mistaken for a UTI but requires different management.
- Sexually Transmitted Infections (STIs) like Chlamydia or Gonorrhea: These can cause symptoms similar to UTIs, including dysuria, and are critical to diagnose and treat to prevent long-term complications.
- Tuberculosis of the Urinary Tract: Though rare, it can cause chronic symptoms including dysuria and needs to be considered in the appropriate clinical context.
Rare Diagnoses
- Bladder Cancer: Can cause irritative voiding symptoms, including dysuria, though this is much less common and typically seen in older adults with other risk factors.
- Sjögren's Syndrome: An autoimmune disorder that can cause dryness in mucous membranes, including the bladder, leading to symptoms of interstitial cystitis.
- Vulvar Dermatoses: Certain skin conditions of the vulva can cause irritation and burning, potentially worsening with urination.