What is painful urination (dysuria)?

The term “dysuria” refers to any pain or discomfort associated with urination (peeing). It does not refer to urinary frequency (how often you go), though disorders of frequency can often be accompanied by dysuria.

Who experiences painful urination?

Men and women of any age can experience painful urination.

It is more common in women. It is most commonly associated with urinary tract infections, which more often affect women than men.

Pregnant women, men and women with diabetes, and men and women with any type of disease of the bladder are at higher risk of dysuria.

What are the causes of painful urination?

Painful urination for women can be the result of:

  • Vaginal infection
  • Urinary tract infection
  • Inflammation of the urethra (the tube that connects the bladder and genitals) or vagina that may be related to dietary factors

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

Painful urination for men may be the result of:

  • Urinary tract infection
  • Prostate disease
  • Cancer

Painful urination for both genders may be the result of a sexually transmitted infection (STI) or the side effect of medications. Chemotherapy cancer drugs or radiation treatments to the pelvic area may inflame the bladder and cause painful urination.

What are the symptoms of painful urination?

Symptoms of painful urination can vary between men and women, but both genders usually experience it as a burning, stinging, or itching feeling. The pain can be at the start of urination or after urination.

Pain at the start of urination is often the symptom of a urinary tract infection. Pain after urination can indicate a problem with the bladder or prostate. For many male patients, pain can persist in the penis before and after urination, too.

Symptoms for female patients can be internal or external. Pain on the outside of the vaginal area may be caused by inflammation or irritation of this sensitive skin. An internal pain can be a symptom of a urinary tract infection.

How is painful urination diagnosed?

Both men and women who experience painful urination should see a doctor. Dysuria can be a symptom of a broader physical condition that may need treatment.

Your doctor will usually be able to diagnose the cause of your painful urination by a description of your symptoms and the analysis of a urine sample. This sample will be analyzed for white blood cells, red blood cells, or foreign chemicals. The presence of white blood cells will tell your doctor if you have inflammation in the urinary tract.

A urine culture, which takes approximately 2 days for final results, will reveal if there is infection and which bacteria are causing a urinary tract infection. It also lets your provider know which antibiotics would work in treating the bacteria.

If no sign of infection is found in your urine sample, your doctor may suggest additional tests to look at the bladder or prostate.

For female patients, the doctor may also take a swab sample of the lining of the vagina or the urethra to check for signs of infection.

Your doctor will also take a medical history, including questions about medical conditions you may have, 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.

How is painful urination treated?

Treatment for dysuria depends on the cause of the pain. Determining whether painful urination is caused by infection, inflammation, dietary factors or a problem with the bladder or prostate is the first step in your treatment. Urinary tract infections are most commonly treated with a course of antibiotics.

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.

There are several steps you can take to reduce the discomfort of painful urination, including drinking more water or taking an over-the-counter aid (such as Uristat® or AZO®) to treat painful urination. Other treatments need prescription medications.

If you suffer from frequent urinary tract infections, your doctor can help look into the underlying cause of this condition.

References:
  • Merck Manual. Dysuria Accessed 2/8/2017.
  • 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 Accessed 2/8/2017.
  • Kurowski K. The women with dysuria. Am Fam Physician. 1998 May 1;57(9):2155-64, 2169-70.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/27/2016…#15176