Dysuria is the medical term for pain or discomfort when urinating. Often described as a burning sensation, dysuria is caused by bacterial infections of the urinary tract. Dysuria is a common symptom of a bladder infection (cystitis). Cystitis is very common in women aged 20 to 50. An infection often starts when bacteria enter the opening where urine comes out (urethra) during sexual intercourse. Bacteria also can enter the urethra in women and girls who wipe with toilet tissue from back to front. Once bacteria enter a woman's urethra, it only has to travel a short distance to the bladder. In men over age 50, a bladder infection usually is associated with an enlarged prostate or prostate infection.
Causes
Infection of the urinary tract (urethra, bladder, or kidneys) is the most common cause of dysuria. The most common type of infections are cystitis (bladder infection), pyelonephritis (kidney infection), prostatitis (prostate infection), and urethritis (inflammation of the tube, the urethra, that drains the bladder to the outside of the body). Other causes of dysuria include:
- Trauma: local injury or irritation due to catheter placement or sexual contact
- Anatomic obstructions/malformations: obstruction due to an enlarged prostate or urethral stricture
- Pain due to external lesions on the genitalia: Urine touching the lesion causes pain
- External irritation or reaction: frequent douching or application of irritating/allergenic products
Symptoms
Depending on the cause of dysuria, there may be other symptoms in addition to pain when urinating. Symptoms can include:
- Lower urinary tract infection (cystitis) — Frequent urination, an intense urge to urinate, loss of bladder control, pain in the lower front portion of the abdomen, cloudy urine that may have a strong odor, bloody urine
- Upper urinary tract infection (pyelonephritis) — Pain in the upper back, high fever with shaking chills, nausea and vomiting, cloudy urine, frequent urination, an intense urge to urinate
- Urethritis — A discharge from the urethra, redness around the opening of the urethra, frequent urination, vaginal discharge. Partners of people with urethritis that comes from a sexually transmitted disease often will not have any symptoms.
- Vaginitis — Pain, soreness or itching in the vagina, an abnormal or foul-smelling vaginal discharge or odor, pain or discomfort during sexual intercourse
How Is Dysuria Diagnosed?
Your health-care professional will first review your history, which will include questions about your overall health and previous episodes of dysuria. Information about the frequency of urination and sexual and social history will often be included. The extent of the physical examination will depend to some extent on the history information.
When to see a doctor
Contact your doctor or make an appointment if:
- Your painful urination persists
- You have drainage or discharge from your penis or vagina
- Your urine is foul-smelling or cloudy, or you see blood in your urine
- You pass a kidney or bladder (urinary tract) stone
- If you're pregnant, tell your doctor about any pain you have when you urinate.
Treatment
Cystitis and pyelonephritis — These infections, usually caused by bacteria, can be cured with antibiotics taken by mouth. Antibiotics may be given into a vein (intravenously) for severe pyelonephritis with high fever, shaking chills and vomiting.
Urethritis — Urethritis is treated with antibiotics. The type of antibiotic used depends on which infection causes the urethritis.
A single episode of infection in the bladder, urethra, vagina or kidney usually goes away completely after treatment with antibiotics if treated promptly. In most cases, there is very little risk of long-term damage. However, women with certain sexually transmitted diseases can lead to scarring of the reproductive tract and fertility problems if not diagnosed and treated.
