Painful Urination ( Dysuria)

painful urination

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Painful urination (or dysuria) is the pain, burning sensation, itching, or stinging at the tip of the penis (in the genital area in women) or in the lower abdomen when urinating. Symptoms can occur just after urination or remain constant, regardless of urination. In females, this continuous discomfort might increase while sitting.

Painful urination occurs because of inflammation of the urethra (the tube that carries the urine out) and the bladder. Infections, irritating substances (like soaps), and urine composition changes are the possible causes of inflammation and painful urination.

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

Causes of painful urination in women

  • Cystitis (commonly known as UTI);
  • 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.

During the period

  • Concurrent cystitis (or UTI);
  • endometriosis is another possible reason. In this case, other symptoms are painful menstruation, pain during sexual activity other than.

During ovulation

  • Concurrent cystitis (or UTI);
  • ovulation can exacerbate the bladder pain of concomitant interstitial cystitis (a chronic bladder pain syndrome).

During pregnancy

In early pregnancy, this symptom is very uncommon. Later in pregnancy, it is reasonable to have sporadic and transitory painful urination. It is merely due to a growing uterus and will subside without the need for further treatment. However, if the urination is progressively painful and getting worse, it may be a UTI symptom and requires treatment.

Causes of painful urination in men (often are STDs)

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

A less common cause of burning or pain in the genital area is chronic or intermittent bladder catheterization in patients with urinary retention.

Causes of painful urination in child

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

Causes of painful urination without infection

  • The overfull bladder can cause transitory pain while urinating, often in the morning after waking up, because of bladder stretching while contracting;
  • Dehydration, which makes the urine more concentrated and irritating 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 dysuria;
  • Febrile diseases like influenza, SARS-COVID 19, and other virosis, through dehydration and urine concentration, can irritate the urethra and make the 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 painful urination;
  • 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 use almost always antibiotics.

The correct treatment should be prescribed by the doctor, according to the type of infection. Incorrect use of antibiotics might get it worse, get it 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)