What Causes Painful Urination

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Dysuria (Painful Urination)

Dysuria means you feel pain or a burning sensation when you pee (urinate). Men and women of any age can experience dysuria, but it’s more common in women. Urinary tract infections are commonly associated with dysuria. Treatment depends on the cause and ranges from antibiotics, to avoiding irritants to treating the underlying medical problem.

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Overview

What is dysuria (painful urination)?

Dysuria is pain or discomfort when you urinate (pee). It burns! Dysuria isn’t about how often you go (urinary frequency), though urinary frequency often happens together with dysuria. Dysuria is not a diagnosis. It’s a sign or symptom of an underlying health problem.

Who gets dysuria (painful urination)?

Men and women of any age can experience painful urination. It’s more common in women. Urinary tract infections (UTIs) are commonly associated with dysuria. UTIs occur in more women than men.

Other people at a higher risk of dysuria include:

Pregnant women.
Men and women with diabetes.
Men and women with any type of disease of the bladder.

What are the symptoms of dysuria (painful urination)?

Symptoms of painful urination can vary between men and women, but both genders usually describe it as a burning, stinging or itching. Burning is the most commonly reported symptom.

Pain can occur at the start of urination or after urination. Pain at the start of your urination is often a symptom of a urinary tract infection. Pain after your urination can be a sign of a problem with the bladder or prostate. In men, pain can remain in your penis before and after urination too.

Symptoms in women can be internal or external. Pain outside your vaginal area may be caused by inflammation or irritation of this sensitive skin. Internal pain can be a symptom of a urinary tract infection.

How is dysuria (painful urination) diagnosed?

See your healthcare provider if you feel pain or burning when you pee. Dysuria can be a symptom of medical condition that may need to be treated. To diagnose your pain, first your healthcare provider will review your complete medical history, including asking you questions about your current and past medical conditions, such as diabetes mellitus or immunodeficiency disorders. He or she may also ask about your sexual history to determine if an STI could be the cause of the pain. Tests to screen for STIs may also be needed, especially if men have a discharge from their penis or women have discharge from their vagina. If you are a woman of childbearing age, a pregnancy test may be done.

Your provider will also ask about your current prescriptions and over-the-counter medication use and any tried “home remedies” to manage the dysuria.

Your healthcare provider will also ask you about your current symptoms and obtain a clean catch sample of your urine. Your urine sample will be analyzed for white blood cells, red blood cells or foreign chemicals. The presence of white blood cells tells your provider you have inflammation in your urinary tract. A urine culture reveals if you have a urinary tract infection and if so, the bacteria that are causing it. This information allows your provider to select the antibiotic that will work best in treating the bacteria.

If no sign of infection is found in your urine sample, your healthcare providers may suggest additional tests to look at your bladder or prostate (in men). Your provider may also take a swab sample of the lining of your vagina or the urethra to check for signs of infection (in women).

Possible Causes

What are the causes of dysuria (painful urination)?

There are many causes of dysuria. Also know that doctors can’t always identify the cause.

WOMEN: Painful urination for women can be the result of:

Bladder infection (cystitis).
Vaginal infection.
Urinary tract infection.
Endometritis and other causes outside the urinary tract, including diverticulosis and diverticulitis.
Inflammation of the bladder or urethra (urethritis) (Your urethra is the tube that begins at the lower opening of your bladder and exits out of your body). Inflammation is usually caused by an infection.

The inflammation may also be caused by sexual intercourse, douches, soaps, scented toilet paper, contraceptive sponges or spermicides.

Normal female anatomy

MEN: Painful urination for men may be the result of:

Urinary tract infection and other infections outside the urinary tract, including diverticulosis and diverticulitis.
Prostate disease.
Cancer.

Normal male anatomy

Painful urination for men and women may be the result of a sexually transmitted infections (STIs) or the side effect of medications. Chemotherapy cancer drugs or radiation treatments to the pelvic area may inflame the bladder and cause painful urination.

Care and Treatment

How is dysuria (painful urination) treated?

Treatment for dysuria depends on the cause of your pain/burning sensation. The first step in your treatment is to determine if your painful urination is caused by infection, inflammation, dietary factors, or a problem with your bladder or prostate.

Urinary tract infections are most commonly treated with antibiotics. If your pain is severe, you may be prescribed phenazopyridine. Note: this medication turns you urine red-orange and stains undergarments.
Inflammation caused by irritation to the skin is usually treated by avoiding the cause of the irritant.
Dysuria caused by an underlying bladder or prostate condition is treated by addressing the underlying condition.

Can anything be done to prevent dysuria?

Drink more water. Drink two to three liters of water a day.
If you wear a urinary incontinence pad, change it as soon as it gets soiled.
After you (a woman) urinates, take some additional new tissue and wipe away any urine from the inside of your vaginal lips.

When to Call the Doctor

When should I call my healthcare provider?

Dysuria is a symptom. It causes a burning sensation, pain and/or discomfort. You will likely choose to contact your healthcare provider because this symptom is uncomfortable. It’s important to see your provider to determine if your symptom is related to a urinary tract infection or another medical cause. In any case, the sooner you see your provider, the sooner a diagnosis can be made and treatment can be started.

Last reviewed by a Cleveland Clinic medical professional on 12/08/2020.

References

Merck Manual. Dysuria. (http://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/symptoms-of-kidney-and-urinary-tract-disorders/urination,-pain-or-burning-with) Accessed 12/1/2020.
American Academy of Family Physicians. Painful Urination. (https://familydoctor.org/urinary-tract-infections-causes-painful-urination/) Accessed 12/1/2020.
Wrenn K. Dysuria, Frequency, and Urgency. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths; 1990. Chapter 181. ncbi.nlm.nih.gov. (http://www.ncbi.nlm.nih.gov/books/NBK291/) Accessed 12/1/2020.
Kurowski K. The women with dysuria. Am Fam Physician. 1998 May 1;57(9):2155-64, 2169-70. Accessed 12/1/2020.

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What Causes Painful Urination?

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You may experience painful urination due to infections, irritation from hygiene products, kidney stones, or other medical conditions, including inflammation of the urethra or prostate.

Painful urination (dysuria) is a broad term that describes discomfort during urination. This pain may originate in the bladder, urethra, or perineum. The urethra is the tube that carries urine outside of your body.

In those with a penis, the area between the scrotum and the anus is known as the perineum. In those with a vagina, the perineum is the area between the anus and the opening of the vagina.

Painful urination is very common. Pain, burning, or stinging can indicate a number of medical conditions.

Urinary tract infections

Painful urination is a common sign of a urinary tract infection (UTI). A UTI can be the result of a bacterial infection. It can also be due to inflammation of the urinary tract.

The urethra, bladder, ureters, and kidneys make up your urinary tract. The ureters are tubes that carry urine from the kidneys to the bladder. Inflammation in any of these organs can cause pain during urination.

People with a vagina are more likely to develop UTIs than people with a penis. This is because the urethra is shorter in those with a vagina. A shorter urethra means that bacteria have a shorter distance to travel to reach the bladder.

People who are pregnant or menopausal also have an increased risk of developing urinary tract infections.

Sexually transmitted infections (STIs)

You may also experience pain when urinating if you have acquired a sexually transmitted infection (STI). Some STIs that may cause painful urination include genital herpes, gonorrhea, and chlamydia.

It’s important to be screened for STIs, especially because they don’t always have symptoms. Many people who are sexually active should get tested for STIs.

Prostatitis

Other medical conditions can cause painful urination. People with a prostate may experience painful urination due to prostatitis. This condition is the inflammation of the prostate gland. It’s a primary cause of urinary burning, stinging, and discomfort.

Cystitis

Another cause of painful urination is cystitis or the inflammation of the bladder’s lining. Interstitial cystitis (IC) is also known as painful bladder syndrome. It’s the most common type of cystitis. Symptoms of IC include pain and tenderness in the bladder and pelvic region.

In some cases, radiation therapy can cause bladder and urinary pain. This condition is known as radiation cystitis.

Urethritis

Urethritis indicates that the urethra has become inflamed, usually due to an infection by bacteria. Urethritis often causes pain while urinating and can also cause an increased urge to urinate.

Epididymitis

Painful urination can also be caused by epididymitis, or inflammation of the epididymis in those with a penis. The epididymis is located at the back of the testicles and stores and moves sperm from the testes.

Pelvic inflammatory disease (PID)

PID can affect the fallopian tubes, ovaries, cervix, and uterus. It can cause pain in the abdomen, painful sex, and painful urination, among other symptoms.

PID is a serious infection that is usually caused by an initial bacterial infection in the vagina that then moves into the reproductive organs.

Obstructive uropathy

Obstructive uropathy is when an obstruction in the ureter, bladder, or urethra causes urine to flow back into the kidneys. Causes vary, but it’s important to seek medical help when symptoms occur.

Another condition, urethral stricture, can cause narrowing in the urethra, causing similar issues with urination and pain.

Kidney stones

You may have difficulty urinating comfortably if you have kidney stones. Kidney stones are masses of hardened material located in the urinary tract.

Medications

Certain medications, such as those for cancer treatments and some antibiotics, can have painful urination as a side effect. Talk to your healthcare provider about any side effects to medications you may be taking.

Hygiene products

Sometimes painful urination isn’t due to an infection. It can also be caused by products that you use in the genital regions. Soaps, lotions, and bubble baths can irritate vaginal tissues especially.

Dyes in laundry detergents and other toiletry products can also cause irritation and lead to painful urination.

Determining the cause of the pain will be the first step before treatment.

Your doctor may prescribe medication to treat painful urination. Antibiotics can treat UTIs, some bacterial infections, and some STIs. Your doctor may also give you medication to calm your irritated bladder.

Painful urination due to a bacterial infection usually improves fairly quickly after you start taking medication. Always take the medication exactly as your doctor prescribes.

Pain associated with some infections, such as interstitial cystitis, may be more challenging to treat. Results from drug therapy may be slower. You may have to take medication for up to 4 months before you start to feel better.

There are changes you can make to your lifestyle to help relieve your symptoms.

Steer clear of scented laundry detergents and toiletries to reduce your risk of irritation.
Use condoms or other barrier methods during sexual activity.
Modify your diet to eliminate food and drinks that can irritate the bladder (such as highly acidic foods, caffeine, and alcohol ).
Stay well hydrated.

Contact your healthcare provider:

if the pain is persistent or long-lasting
if you’re pregnant
the pain is accompanied by a fever
if you experience discharge from your penis or vagina
if your urine has a different odor, has blood in it, or is cloudy
if the pain is accompanied by abdominal pain
if you pass a bladder or kidney stone

Your doctor may ask about other symptoms and request lab work to help determine the cause of the pain.

Last medically reviewed on December 8, 2020

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