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  #1  
Old 05-16-2012
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ObGyn Urgency and Anterior Vaginal Wall Tenderness

A 47 -year-old woman presents to your office with complaints of lower abdominal pain, nocturia, urinary urgency and frequency relieved with urination. She states the symptoms have been worsening this past month and she recently experienced dyspareunia. She is sexually active with her husband, but this is causing her a great amount of pain. She has four children and had uncomplicated pregnancies. She denies fevers or chills. On examination, she has diffuse lower abdominal pain with no rebound or guarding. Her external genitalia appear normal. On bimanual examination, palpation of the anterior vaginal wall elicits extreme pain. No cervical motion tenderness is present. No other abnormalities are noted. A urinalysis is negative. The most likely diagnosis is:

A. Urinary tract infection
B. Stress incontinence
C. Cystocele
D. Interstitial cystitis
E. Pelvic inflammatory disease
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Old 05-16-2012
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Interstitial cystitis
Uti sx with negative urinalysis & tender bladder
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Old 05-16-2012
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it's either cystocele or interstitial cystitis......probably interstitial
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Old 05-16-2012
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Yea actually cystocele present with chronic low abd pain and bulging in ant vaginal wall and dysparunia maybe. in multipra but dosent explain tenderness which is typical for interstitial cystitis
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