Differential Diagnosis for Dysuria and Suprapubic Pain
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of dysuria and suprapubic pain, especially in women. The symptoms are classic for a lower urinary tract infection, which includes cystitis.
Other Likely Diagnoses
- Vaginitis: Inflammation of the vagina, often due to infection, can cause dysuria, especially if the inflammation involves the urethral meatus.
- Urethral Syndrome: A condition characterized by symptoms of a UTI without evidence of infection, possibly due to urethral irritation or inflammation.
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can mimic the symptoms of a UTI.
- Kidney Stones: While often associated with flank pain, small stones or stones in the distal ureter can cause suprapubic pain and dysuria.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with right lower quadrant pain, an inflamed appendix located near the bladder or ureter can cause suprapubic pain and dysuria.
- Ectopic Pregnancy: A pregnancy developing outside the uterus can cause severe abdominal pain, including suprapubic pain, and if it involves the urinary system, dysuria.
- Diverticulitis: Inflammation of a diverticulum in the sigmoid colon can cause left lower quadrant pain but can also refer pain to the suprapubic area if the inflammation involves the bladder or ureter.
- Ovarian Cyst or Torsion: These conditions can cause severe pelvic pain that might be referred to the suprapubic area and could potentially irritate the urinary tract, causing dysuria.
Rare Diagnoses
- Bladder Cancer: While rare, especially in younger populations, bladder cancer can cause symptoms similar to those of a UTI, including dysuria and suprapubic pain.
- Schistosomiasis: A parasitic infection that can involve the bladder, causing chronic inflammation, dysuria, and suprapubic pain, more common in travelers to or natives of endemic areas.
- Tuberculosis of the Urinary Tract: A rare condition in many parts of the world, it can cause chronic symptoms including dysuria, suprapubic pain, and systemic symptoms like weight loss and fever.
- Endometriosis: Although primarily causing pelvic pain related to menstruation, in rare cases, endometrial implants can involve the bladder, leading to dysuria and suprapubic pain, especially during menses.