Differential Diagnosis for a 20-year-old male with suprapubic pains and urination
- Single most likely diagnosis
- Urinary Tract Infection (UTI): Although the urine test is negative, UTIs can sometimes present with negative urine cultures, especially if the patient has recently taken antibiotics or has a partially treated infection. The symptoms of suprapubic pain and pain with urination are classic for a UTI.
- Other Likely diagnoses
- Prostatitis: This is an inflammation of the prostate gland and can cause suprapubic pain, pain with urination, and sometimes fever. The absence of discharge does not rule out prostatitis.
- Interstitial Cystitis: A condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. The pain can be exacerbated by urination.
- Overactive Bladder: This condition can cause urinary urgency, frequency, and suprapubic pain, especially if the bladder is not fully emptied during urination.
- Do Not Miss diagnoses
- Testicular Torsion: Although this typically presents with acute testicular pain, it can sometimes cause referred pain to the suprapubic area. This is a medical emergency that requires prompt attention.
- Kidney Stone: A stone in the urinary tract can cause severe pain, including suprapubic pain, and may not always be detected by a urine test.
- Appendicitis: In some cases, appendicitis can present with suprapubic pain, especially if the appendix is located near the bladder.
- Rare diagnoses
- Bladder Cancer: Although rare in young adults, bladder cancer can cause suprapubic pain, hematuria (which may not always be visible), and other urinary symptoms.
- Schistosomiasis: A parasitic infection that can cause urinary symptoms, including suprapubic pain and hematuria, although this is more common in endemic areas.