Dysuria (Painful Urination)

What is dysuria (painful urination)?

Dysuria is pain or discomfort when you urinate (pee). It burns! Dysuria isn’t about how often you go (urinary frequency), though urinary frequency often happens together with dysuria. Dysuria is not a diagnosis. It’s a sign or symptom of an underlying health problem.

Who gets dysuria (painful urination)?

Men and women of any age can experience painful urination. It’s more common in women. Urinary tract infections (UTIs) are commonly associated with dysuria. UTIs occur in more women than men.

Other people at a higher risk of dysuria include:

• Pregnant women.
• Men and women with diabetes.
• Men and women with any type of disease of the bladder.

What are the symptoms of dysuria (painful urination)?

Symptoms of painful urination can vary between men and women, but both genders usually describe it as a burning, stinging or itching. Burning is the most commonly reported symptom.

Pain can occur at the start of urination or after urination. Pain at the start of your urination is often a symptom of a urinary tract infection. Pain after your urination can be a sign of a problem with the bladder or prostate. In men, pain can remain in your penis before and after urination too.

Symptoms in women can be internal or external. Pain outside your vaginal area may be caused by inflammation or irritation of this sensitive skin. Internal pain can be a symptom of a urinary tract infection.

How is dysuria (painful urination) diagnosed?

See your healthcare provider if you feel pain or burning when you pee. Dysuria can be a symptom of medical condition that may need to be treated. To diagnose your pain, first your healthcare provider will review your complete medical history, including asking you questions about your current and past medical conditions, 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, especially if men have a discharge from their penis or women have discharge from their vagina. If you are a woman of childbearing age, a pregnancy test may be done.

Your provider will also ask about your current prescriptions and over-the-counter medication use and any tried “home remedies” to manage the dysuria.

Your healthcare provider will also ask you about your current symptoms and obtain a clean catch sample of your urine. Your urine sample will be analyzed for white blood cells, red blood cells or foreign chemicals. The presence of white blood cells tells your provider you have inflammation in your urinary tract. A urine culture reveals if you have a urinary tract infection and if so, the bacteria that are causing it. This information allows your provider to select the antibiotic that will work best in treating the bacteria.

If no sign of infection is found in your urine sample, your healthcare providers may suggest additional tests to look at your bladder or prostate (in men). Your provider may also take a swab sample of the lining of your vagina or the urethra to check for signs of infection (in women).

What are the causes of dysuria (painful urination)?

There are many causes of dysuria. Also know that doctors can’t always identify the cause.

WOMEN: Painful urination for women can be the result of:

• Bladder infection (cystitis).
• Vaginal infection.
• Urinary tract infection.
• Endometritis and other causes outside the urinary tract, including diverticulosis and diverticulitis.
• Inflammation of the bladder or urethra (urethritis) (Your urethra is the tube that begins at the lower opening of your bladder and exits out of your body). Inflammation is usually caused by an infection.

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

MEN: Painful urination for men may be the result of:

• Urinary tract infection and other infections outside the urinary tract, including diverticulosis and diverticulitis.
• Prostate disease.
• Cancer.

Painful urination for men and women may be the result of a sexually transmitted infections (STIs) or the side effect of medications. Chemotherapy cancer drugs or radiation treatments to the pelvic area may inflame the bladder and cause painful urination.

How is dysuria (painful urination) treated?

Treatment for dysuria depends on the cause of your pain/burning sensation. The first step in your treatment is to determine if your painful urination is caused by infection, inflammation, dietary factors, or a problem with your bladder or prostate.

• Urinary tract infections are most commonly treated with antibiotics. If your pain is severe, you may be prescribed phenazopyridine. Note: this medication turns you urine red-orange and stains undergarments.
• 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 have frequent urinary tract infections, your provider can help find the cause.

Can anything be done to prevent dysuria?

• Drink more water. Drink two to three liters of water a day.
• If you wear a urinary incontinence pad, change it as soon as it gets soiled.
• After you (a woman) urinates, take some additional new tissue and wipe away any urine from the inside of your vaginal lips.

When should I call my healthcare provider?

Dysuria is a symptom. It causes a burning sensation, pain and/or discomfort. You will likely choose to contact your healthcare provider because this symptom is uncomfortable. It's important to see your provider to determine if your symptom is related to a urinary tract infection or another medical cause. In any case, the sooner you see your provider, the sooner a diagnosis can be made and treatment can be started.