Dysuria (Painful Urination, Urination Discomfort
Dysuria is the feeling of pain, burning, or discomfort upon urination. Although dysuria frequently indicates the presence of a urinary tract infection (UTI), it can have a variety of causes. Dysuria should always trigger a visit to a health-care professional for evaluation and diagnosis.
Dysuria is common, for from 5%-15% of visits to a primary-care doctor are for symptoms of dysuria. Symptoms occur more commonly in women, especially in young women and people who are sexually active. Most of the time, dysuria will be caused by a simple urinary tract infection, but a complete evaluation by a health-care professional is necessary for proper diagnosis, especially if the symptoms reoccur.
Infection of the urinary tract (urethra, bladder, or kidneys) is the most common cause of dysuria. The most common type of infections arecystitis (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). Sexually transmitted diseases can also produce symptoms of dysuria.
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
- Hormonal: postmenopausal effects
- Neurologic conditions: any nerve conditions that cause difficulty with bladder emptying
- Cancer: kidney tumor, bladder, prostate, vaginal/vulvar, or penile cancer
- Medical conditions: diabetes mellitus and other chronic conditions that suppress the immune system
When to Seek Medical Care
Any patient experiencing symptoms of dysuria should seek medical attention.
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. The examination will usually include an abdominal examination and often an examination of the external genitalia and a gynecologic examination for women.
A urine sample will be obtained. In the office, a dipstick test of the urine can often be done and give further clues to the cause of the dysuria. These dipstick tests can indicate the presence of bacteria and blood (both common in patients with an urinary tract infection). The sample then is sent to the laboratory where it is examined under the microscope (to confirm the presence of blood or white blood cells). A culture of the urine is performed to see if bacteria grow (both confirming a bacterial infection as well as identifying the exact bacteria causing the infection
The most common cause of dysuria is a urinary tract infection. Infections are treated withantibiotics. Based on the current pattern of urinary tract infections in your community, your health-care professional will chose the optimal medication. If a culture indicates that bacteria are present that are resistant to the initial antibiotic, your doctor might change the medication once the results of the culture are known.
If the cause of the dysuria is not infectious, your health-care professional may order further tests and treatments.
Self-Care at Home
Dysuria usually requires an evaluation by a health-care professional and should not be treated without medical supervision.
Your medical professional will chose the optimal medication for your condition. If it is an infection, an antibiotic will be prescribed and you should take the full course of the medication, even if you feel better.
Pain medication is sometimes given in the form of a general analgesic or a specific product that will numb the pain in the urinary tract. It is important to follow the instructions for these products closely.
An uncomplicated urinary tract infection usually does not require follow-up. Should you get frequent infections, further evaluation might be warranted, including a referral to a urologist and sometimes other testing such as ultrasound tests.
Urinating at bedtime and after sexual intercourse, not holding urine for an excessive amount of time, and good hygiene can decrease the chances of developing a urinary tract infection. Of note, these are only helpful hints as they will not guarantee prevention. Avoid any irritating product on the outside of your genitals if you are experiencing dysuria.
Most urinary tract infections will improve with appropriate antibiotics and should have no long-term consequences.
Synonyms and Keywords
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