What is dysuria?
Dysuria is the medical term for painful urination or a burning sensation, discomfort, or difficulty when passing urine. In most cases, dysuria is a symptom of another medical condition.
Males and females of any age can experience dysuria. However, this symptom is more common in women. Dysuria is also commonly associated with urinary tract infections (UTIs), which usually affect more women than men. Aside from women, other groups of people who have a higher risk of dysuria are pregnant women, men and women with bladder disease, and men and women with diabetes.
Causes of Dysuria
Dysuria in women can be a result of any of the following conditions:
- Urinary tract infections (UTIs)
- Vaginal infection
- Urethritis (inflammation of the urethra)
- Vaginal inflammation caused by soaps, douches, scented toilet paper, sexual intercourse, spermicides, or contraceptive sponges
When it comes to men, painful urination may be a result of the following:
Causes of painful urination in both genders:
- Sexually transmitted infections (STIs)
- Bladder stones
- Kidney stones
- Medication side effect
- The use of certain chemotherapy drugs
- Radiation therapy to the pelvis
Other causes of painful urination may include:
- Irritation or local injury caused by sexual intercourse, catheter insertion, bicycling, or horseback riding
- An obstruction caused by urethral stricture or an enlarged prostate
- External genital lesions
- Frequent use of irritating products or douching
- Hormonal issues (vaginal dryness or postmenopausal effects)
- Neurological disorders that affect complete bladder emptying
- Diabetes mellitus and other medical conditions that weaken the immune system
- Bladder cancer
- Urethral cancer
- Penile cancer
- Prostate cancer
- Vaginal and vulvar cancers
Symptoms of Dysuria
The symptoms of dysuria usually vary among men and women. However, both genders commonly experience pain at the start of urination or after urination along with a stinging, burning, or itching sensation.
In most cases, pain at the start of urination is a symptom of UTI. When pain is felt after urination, it may indicate prostate or bladder problems. In males, penile pain can also persist before and after urination. In females, the symptoms of dysuria can be external or internal. The pain felt on the external vaginal area may be due to irritation or inflammation of sensitive skin while an internal pain can be a symptom of UTI.
Other Symptoms that Accompany Dysuria
- Genital itching
- Genital swelling
- Cloudy urine
- Bad-smelling urine
- Foul-smelling discharge
- Hematuria (presence of blood in urine)
- Abdominal pain
- Back or side pain
- Painful ejaculation or bowel movements in males
- Urinary urgency but with little to no urine passed
When to See a Doctor
See your healthcare provider right away if you experience any of the following signs and symptoms:
- Painful urination
- Joint pain
- Skin rash
- Fever (38 degrees Celsius or 100.4 degrees Fahrenheit or higher)
- No significant improvement after three days of treatment
- Increased vaginal or penile discharge
- Worsening back pain or abdominal pain
- Swollen and painful lumps in the groin
Evaluation and Diagnosis of Dysuria
Your healthcare provider will initially take your medical history and perform a physical examination. The doctor may also request certain laboratory tests to determine the cause of your symptoms. Targeted treatment follows after a diagnosis has been made.
The doctor may ask the following questions regarding your painful urination:
- Did the symptoms gradually or suddenly start?
- How frequently have you experienced the symptoms? Once or many times?
- Is pain felt at the start of urination or after urination?
You may also be asked if painful urination is also accompanied by the following symptoms:
- Flank pain
- Abnormal vaginal or penile discharge
Other questions may include:
- Changes in urine flow (difficulty initiating urine flow, urinary urgency, dribbling)
- Changes in urine along with painful urination (change in color, amount of urine voided, the presence of blood in urine, pus in urine, cloudy urine)
Your healthcare provider will have clues to the cause of your painful urination if your answer these questions. A urine test along with other tests are needed to help confirm your doctor's diagnosis.
- Dipstick Test: A sample of urine will be collected. In your doctor's office, a dipstick test can be done to give more clues about your condition. This test can indicate the presence of blood and bacteria, which are commonly found in people with urinary tract infections. The urine sample is then sent to the laboratory for further analysis under the microscope. A microscopic examination can confirm the presence of red blood cells (RBCs) and white blood cells (WBCs) in the urine sample.
- Urine Culture: A urine culture may be recommended by your healthcare provider to confirm any bacterial infection and the specific type of bacteria causing the infection.
- Blood Test: A blood test may be performed to identify any signs of infection.
- Cystoscopy: A cystoscopy is a procedure that enables your healthcare provider to look for problems in your bladder. The procedure uses a cystoscope, which has lenses similar to a telescope or microscope.
- Ultrasound: An ultrasound is an imaging technique that uses sound waves to view internal images of the body, including the detection of bladder problems.
Treatment for Dysuria
Treatment for dysuria usually depends on its cause. People may need antibiotic treatment if they have a bacterial infection. Other people may also be given medications to help relieve painful urination. If dysuria is left undiagnosed and untreated, symptoms may get worse. Your healthcare provider can explain more about the best treatment option for your condition.
You may also be referred to a specialist, such as a nephrologist or a urologist for further evaluation and testing.
Managing Dysuria at Home
- Drink plenty of liquids - Drinking plenty of liquids can help flush out bacteria that may be causing your infection. You can ask your healthcare provider which liquids are best for you to take and how much liquid you are allowed to drink every day.
- Sitz bath - You can take a sitz bath as directed by your healthcare provider. To prepare a sitz bath, fill a bathtub around 4-6 inches of warm water. Another method is to use a sitz bath pan that fits over the toilet. Take a sitz bath 2-3 times a day for 20 minutes or according to the recommendation of your healthcare provider. The warm water in the sitz bath can help relieve swelling and pain in the genital area.