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Urination - painful

Dysuria; Painful urination

 

Painful urination is any pain, discomfort, or burning sensation when passing urine.

Considerations

 

Pain may be felt right where the urine passes out of the body. Or, it may be felt inside the body, behind the pubic bone, or in the bladder or prostate.

Pain on urination is a fairly common problem. People who have pain with urination also may have the urge to urinate more often.

 

Causes

 

Painful urination is most often caused by an infection or inflammation somewhere in the urinary tract. For example it may be a:

Painful urination in women and girls may be due to:

  • Changes in the vaginal tissue during menopause (atrophic vaginitis)
  • Herpes infection in the genital area
  • Irritation of the vaginal tissue caused by bubble bath, perfumes, or lotions
  • Vulvovaginitis, such as yeast or other infections of the vulva and vagina

Other causes of painful urination include:

  • Interstitial cystitis
  • Prostate infection (prostatitis)
  • Radiation cystitis - damage to the bladder lining from radiation therapy to the pelvis area
  • Sexually transmitted infections (STIs) such as gonorrhea or chlamydia

 

When to Contact a Medical Professional

 

Call your health care provider if:

  • There is drainage or a discharge from your penis or vagina.
  • You are pregnant and are having any painful urination.
  • You have painful urination that lasts for more than 1 day.
  • You notice blood in your urine.
  • You have a fever.

 

What to Expect at Your Office Visit

 

Your health care provider will perform a physical exam and ask questions such as:

  • When did the painful urination begin?
  • Does the pain occur only during urination? Does it stop after urination?
  • Do you have other symptoms such as back pain?
  • Have you had a fever higher than 100 degrees F?
  • Is there drainage or discharge between urinations? Is there an abnormal urine odor? Is there blood in the urine?
  • Are there any changes in the volume or frequency of urination?
  • Do you feel the urge to urinate?
  • Are there any rashes or itching in the genital area?
  • What medicines are you taking?
  • Are you pregnant or could you be pregnant?
  • Have you had a bladder infection?
  • Do you have any allergies to any medicines?
  • Have you had sexual intercourse with someone who has, or may have, gonorrhea or chlamydia?
  • Has there been a recent change in your brand of soap, detergent, or fabric softener?
  • Have you had surgery or radiation to your urinary or sexual organs?

A urinalysis will be done. A urine culture may be ordered. If you have had a previous bladder or kidney infection, a more detailed history and physical are needed. Extra lab tests will also be needed. A pelvic exam and exam of vaginal fluids are needed for women and girls who have vaginal discharge. Men who have discharge from the penis will need to have a urethral swab done.

Treatment depends on what is causing the pain.

 

 

References

Ban KM, Easter JS. Selected urologic problems. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 99.

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  • Female urinary tract

    Female urinary tract

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  • Male urinary tract

    Male urinary tract

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    • Female urinary tract

      Female urinary tract

      illustration

    • Male urinary tract

      Male urinary tract

      illustration

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            Review Date: 1/21/2015

            Reviewed By: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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