In medical terms, burning or painful urination is referred to as dysuria. There is pain or discomfort and a sensation of burning when you pass urine.
Painful or burning urine is a symptom or sign of an underlying health problem. Sometimes, it can happen due to holding urine for too long. Generally, it is a telltale sign of a urinary tract infection. Sometimes, the causes can be serious.
Besides burning urine, there is pelvic pain, you pass urine more often, and a general sense of feeling miserable. However, treatment can give quick relief most of the time.
Burning or pain while passing urine is usually felt at the opening of the urethra. It may be also felt less often over the bladder (the lower part of the abdomen).
This is an extremely common symptom in women, but it can affect men and can occur at any age. The risk of a woman having this symptom in her lifetime ranges from 40% to more than 50%.
Who is at greater risk of painful urination?
Although it is more common in women between the ages of 20 to 50 years, men and women of any age can have painful urination. The most common cause of burning or painful urination is urinary tract infections (UTIs), which are more common in women.
Other risk factors that increase the chances of dysuria include:
- Urinary bladder disease
- Intense and more frequent sexual activity
- Imbalance in the vaginal flora
- Age (older adults and young children are more at risk
- Enlarged prostate
There are several causes of urinary pain or burning. In women, urinary tract infection is the most common cause, while in men, urethritis and prostate problems are more commonly associated with dysuria.
Other causes include:
- Stones in the urinary bladder
- Stones in the kidney
- Urinary bladder infection
- Infection in the kidney
- Chlamydia (a sexually transmitted disease)
- Chemotherapy cancer drugs or radiation to the pelvic area
- Genital herpes
- Prolonged catheter use
- A procedure or surgery performed on the urinary tract
- Enlarged prostate
- Improper hygiene of the genitalia
- Urethral stricture
- Infection in the urethra
- Bacterial or yeast infection in the vagina
- Inflammation or infection in the lower urinary tract
- Sensitivity or allergy to douches, soaps, contraceptive sponges, or spermicides
- Immunodeficiency disorders such as Lupus
What are the symptoms of dysuria (painful urination)?
See your doctor when you experience any of the following symptoms and warning signs.
About urine pain
Both men and women describe dysuria as a feeling of burning and pain when passing urine. Depending on the cause there might be itching also.
The burning pain can begin when you start passing the urine or at the end after you have finished passing the urine.
Urinary tract infection often causes pain at the beginning. Pain after passing urine indicates a problem in the urinary bladder or in men, it can be a problem with the prostate. A prostate problem can cause pain in the penis to remain even before and after passing urine.
Women may have pain inside or outside the vagina. Internal pain can be caused mainly by urinary tract infections. External pain can be due to inflammation of the surrounding skin.
Other warning signs
Other accompanying warning signs can include:
- Fever with chills due to infection
- A sudden, strong urge to urinate
- Nocturia – frequent need to urinate at night
- Pain in your flank and back between the last rib and the hipbone
- Pelvic pain
- Urine may be cloudy or may contain blood
- Nausea and vomiting
Diagnosing the cause of painful urination
To arrive at the cause of painful or burning urination, your doctor will order some of the tests described below.
At first, he will take your medical history to look for any existing health condition such as diabetes or an immunodeficient disorder. He will then ask about your symptoms and urine pain.
He will then do a clinical examination. Initially, he will look for any tenderness over the flank or in the pelvic region and then perform a general examination.
In women, the clinical examination will include a pelvic examination and the taking of samples of cervical and vaginal fluid to check for STIs.
In men, he will examine for any discharge from the urethra and further rule out prostate enlargement by doing a digital rectal examination.
Blood and imaging tests
- The first test, your doctor will want to order is a urine routine test to look for any infection and also to rule out diabetes. If the test shows an infection, he will start you on antibiotics or may order an additional urine culture test, which will tell him which antibiotic will best suit your infection.
Your doctor will probe further with tests until he is able to identify the cause of urinary pain.
- In women of reproductive age, your doctor will rule out pregnancy by ordering a pregnancy test.
- He will screen the individual for sexually transmitted diseases
- Do blood tests to evaluate kidney function
- Ultrasound, CT scans, and MRI will help to look for abnormalities in the kidney, urinary bladder, uterus, ovaries, and prostate
- Cystoscopy will help to rule out any abnormality inside the bladder
As mentioned above, painful or burning urination is a symptom of an underlying cause. Treating this symptom therefore essentially lies in treating the underlying condition that has caused painful urination.
- The doctor will advise the patient to avoid using harsh soaps or other chemical irritants around the genitalia that could cause sensitivity issues.
- The doctor will treat urinary tract infections (UTIs) with a course of antibiotics. UTIs can include infection of the urethra (Urethritis), the urinary bladder (Cystitis), the ureter, and the kidney (Pyelonephritis).
- Severe infection of the kidneys may require intravenous antibiotics.
- Similarly, prostatitis treatment (infection of the prostate) will require a course of antibiotics along with alpha-blockers. If the person has chronic bacterial prostatitis, he may require taking antibiotics for up to 12 weeks.
- STIs will also be treated with a course of antibiotics.
- In females, Trichomoniasis and bacterial vaginosis require antibiotics. Yeast infections are treated with oral antifungal drugs and/or as vaginal suppositories or creams.
- The doctor will encourage a person to drink more fluids as this will keep the urine dilute and less painful to pass.