Urine Pain is a highly unpleasant burning sensation at the tip of the penis (in the genital area in women) or in the lower abdomen (in the bladder area) during or immediately after urination. Sometimes this symptom is described as an itching or stinging sensation in the genital area. Urine Pain can also remain constant, regardless of urination. In females, this continuous discomfort might increase while sitting.

Urine Pain results from irritation of the urethra (the tube that carries the urine out) and the bladder. This irritation does stimulate the nerves carrying the pain feeling to the brain. Most frequently, UTIs cause irritation. However, urine composition (hyperacidity) or irritating substances (like soaps and detergents) can cause Urine Pain. 

The diagnostic workup is crucial to identify the causes and set the proper treatment.

Causes of Urine Pain in women

UTI is the most common cause. Vaginal thrush (Candida) is usually harmless, but symptoms can develop if yeast numbers increase. Symptoms include genital itching or burning, a white discharge other than stinging or burning while urinating. Endometriosis is another possible reason. In this case, other symptoms are painful menstruation and pain during sexual activity. Ovulation can exacerbate the bladder pain of concomitant interstitial cystitis (a chronic bladder pain syndrome). In early pregnancy, this symptom is very uncommon. Later in pregnancy, it is reasonable to have sporadic and transitory urine pain. It is merely due to a growing uterus and will subside without further treatment. However, if the urination is progressively painful and worsens, it may be a UTI symptom and require treatment.

Causes of Urine Pain in men (often are STDs)

The leading causes of pain and burning urination in young adult men are urethritis and prostatitis. They can occur along with urethral discharge, painful ejaculation, and sometimes fever. In most cases, these infections are sexually transmitted diseases (STD like gonorrhea, chlamydia, mycoplasma, and herpes).

Causes of Urine Pain in child

Pain during urination in a child is usually a sign of a lower urinary tract infection. Urinary tract infection (UTI) is the second most common bacterial infection in children.

Causes of Urine Pain without infection

UTI is not always the reason for irritation and pain. The urine hyperacidity makes it chemically aggressive and irritates the mucosa of the urinary tract. Also, bladder hyper-contraction or overstretching is a possible reason for pain:

• The overfull bladder can cause transitory pain while urinating, often in the morning after waking up, because of bladder stretching;
• Dehydration, which makes the urine more concentrated and irritates the urethra;
• The use of aggressive soaps, laundry detergents, and toiletries;
• Certain foods are more likely to irritate the bladder and urethra. Some irritants to avoid include alcohol, caffeine, spicy foods, citrus fruits and juices, tomato products, and artificial sweeteners;
• Hungover: it might be associated with urine pain;
• Febrile diseases like influenza, SARS-COVID 19, and other virosis, through dehydration and urine concentration, can irritate the urethra and make urination painful;
• chronic no infective urethritis (Lichen sclerosus);
• the menstrual period: pain during urination is not frequent and might indicate some underlying diseases like endometriosis;

• Immediate after sex, pain while urinating might be due to trauma (especially after prolonged intercourse);
• Painful urination could be related to kidney stones or stones in the ureter (the tube that connects the kidney to the bladder); in this case, frequent urination and low back pain may accompany the urine pain;
• Bladder Pain Syndrome.

Treatment options

The treatment of painful urination depends on the disease that is causing it. Since infectious diseases, sexual or not, are the most frequent causes, we almost always use antibiotics.

The doctor should prescribe the correct treatment according to the type of infection. Incorrect antibiotic use might worsen, become chronic, or increase bacterial resistance.

Progressive worsening painful urination is always a good reason to see a doctor, especially if it comes with discharge, blood, and fever.

External Resources

Painful urination in women (video)

Painful urination in men: Painful Urination? | How To Know If It Is An STD (video)