Differential Diagnosis for Feeling Like You Have to Have a Bowel Movement in Order to Pee

• Single Most Likely Diagnosis
  • Urinary Retention due to Constipation: This condition occurs when the rectum is filled with stool, putting pressure on the urethra and making it difficult to urinate. The feeling of needing to have a bowel movement to pee is a common symptom because the pressure from the stool can be relieved by defecating, temporarily easing the urinary retention.
• Other Likely Diagnoses
  • Prostatitis: Inflammation of the prostate gland can cause urinary retention and discomfort, which might be relieved by bowel movements due to the proximity of the prostate to the rectum.
  • Urinary Tract Infection (UTI): While not directly related to bowel movements, the discomfort and urgency associated with UTIs might lead to the sensation of needing to urinate after a bowel movement due to the relaxation of pelvic muscles.
  • Neurogenic Bladder: Conditions affecting the nerves that control the bladder can lead to abnormal sensations and difficulties with urination, potentially relieved by bowel movements due to changes in abdominal pressure.
• Do Not Miss Diagnoses
  • Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to loss of bladder and bowel control. Early recognition is crucial as delayed treatment can result in permanent damage.
  • Spinal Cord Injury or Compression: Similar to cauda equina syndrome, any injury or compression of the spinal cord can affect bladder and bowel function, leading to unusual sensations and difficulties with urination.
• Rare Diagnoses
  • Fowler's Syndrome: A rare condition characterized by urinary retention in women, often associated with polycystic ovary syndrome (PCOS), which might lead to the sensation of needing to have a bowel movement to urinate due to pelvic floor dysfunction.
  • Dyssynergic Defecation: A condition where the coordination between the pelvic floor muscles and the anal sphincter is impaired, leading to constipation and potentially affecting urinary function due to shared nerve pathways and pelvic floor muscles.