In this article:
- Dysuria refers to a sensation of pain or discomfort while urinating.
- It is often associated with inflammation and a frequent and urgent need to urinate.
- Dysuria may be caused by infectious and non-infectious agents.
- Diagnosis can be difficult as other lower urinary tract symptoms often accompany it.
- It can be alleviated with the help of various medications, depending on the cause.
- Dysuria may be internal (pain in the urethra) or external (inflammation and irritation in genital organs).
- Several self-care and preventive measures can be used to help manage the condition.
What Is Dysuria?
Dysuria is characterized by a feeling of pain in the urethra or urethral meatus (opening) while urinating and is generally accompanied by burning, itching, and stinging.
The pain and burning sensation originate from the pain receptors in the inflamed mucosal lining, which get stimulated when urine comes in contact. The stimulation causes contractions of the bladder muscles and urethra.
Dysuria is usually accompanied by frequent urination and a pressing need to empty your bladder. It is a common symptom experienced by both genders at one time or another.
If the pain starts at the beginning of urination, it may be a urethra-related problem. If the pain occurs at the end of urination, it might be indicative of bladder disorder.
Causes of Dysuria
Dysuria is often a symptom of other health problems rather than a disease in itself and may develop due to the following reasons:
- Urinary tract infections (UTIs): UTIs are the most likely cause of dysuria. These infections are more prevalent among women as their urethra is shorter and straighter in comparison to the long and curved urethra of men.
Thus, bacteria can infect the bladder more quickly in females as less distance is to be covered.
- Medicines: Medications such as chemotherapy drugs may produce inflammation in the bladder.
- Ovarian cysts or kidney stones: Ovarian cysts may press against the bladder, while kidney stones can get stuck near the entrance of the bladder.
- Vaginitis: Infection or irritation in the vaginal area can also cause dysuria.
- Chemicals: The use of vaginal lubricants, contraceptive foams or sponges, soaps, scented toilet paper, douches, and related products that may contain chemical irritants can cause dysuria.
- Sexually transmitted infections: Chlamydia, gonorrhea, and herpes can cause painful urination.
- Interstitial cystitis: Also called painful bladder syndrome, interstitial cystitis is a chronic ailment characterized by pressure, burning, or pain in the bladder.
- Radiation cystitis: Radiation therapy of the pelvic area may damage the bladder lining.
- Urinary catheterization: The presence of a urinary catheter may allow entry of germs into the urinary tract, leading to an infection in the bladder or kidney, commonly known as catheter-associated urinary tract infection (CA-UTI).
- Pyelonephritis: Bacterial infection in the kidney can cause inflammation and pain during urination.
- Atrophic vaginitis: Tissue changes in the vagina occurring post-menopause may cause dysuria.
- Dehydration: Lack of fluid intake or low water body levels may cause discomfort while urinating.
- Prostate infection: Bacterial infection in the prostate gland can cause swelling and painful urination.
Symptoms of Dysuria
Dysuria generally refers to a sensation of pain while urinating. However, it may also be accompanied by the following symptoms:
- Burning or stinging while peeing
- Increased frequency of urination
- Malodor in the urine
- Bloody or discolored urine
- Loss of appetite
- Vomiting and nausea
- Lower back pain
- Abdominal pain
- Wetting incidents (in potty-trained toddlers)
Of all cases dealt by family physicians, 5%-15% are dysuria. This condition may be more common in women, but the incidence of dysuria in men increases with age.
Men above 40 years of age are predisposed to UTIs due to the prevalence of prostatic hyperplasia, which obstructs the bladder outlet. Around 5% of men with urological problems are diagnosed with dysuria.
Diagnosis of Dysuria
The diagnosis of dysuria focuses on finding the cause. The doctor may study your medical history, perform a physical exam, and order tests such as:
- Urinalysis: A urine sample is collected for:
- Visual exam: Checking the appearance of the urine for color and clarity
- Chemical exam: Testing the presence of substances like sugar, protein, bilirubin, etc.
- Microscopic exam: Visualizing a small amount of the sample through a microscope to look for blood cells, crystals, or microbes
- Urine culture: A urine sample is collected and sent to the laboratory for culturing. This assists in the detection of bacteria or fungi, which may be causing infection.
- Ultrasound: The bladder and kidneys are imaged and scanned to check for inflammation or other pathologies.
- Cystoscopy: The inside of the bladder is visualized using a lighted telescope.
- Discharge culture: A pelvic exam may be performed on women having vaginal discharge. The vaginal fluids are collected and sent to the laboratory for culturing.
For men having discharge from the penis, a urethral swab test is done. These tests are performed in a few cases only.
Treatment for Dysuria
The treatment for dysuria is dependent on the underlying reason:
- Cystitis and pyelonephritis: These bacterial infections can be treated with oral antibacterial drugs. For severe pyelonephritis accompanied by shivering, chills, high fever, and vomiting, the antibiotics may be administered intravenously.
- Urethritis: It might result from various infections, which are treated with different antibiotics.
- Vaginitis: If caused by a yeast infection, vaginitis is treated with antifungal drugs, which are available as oral pills, creams, or suppositories inserted in the vagina. For bacterial vaginosis and trichomoniasis, antibiotics are prescribed.
Dysuria caused by a sexually transmitted infection (STI) will only subside when both sexual partners get treated for the STI.
Preventive Self-Care Measures
The following self-care measures can help in preventing dysuria and providing relief:
- Consume coconut water two times a day until the problem subsides.
- Practice relaxation techniques to alleviate stress and tension, which can worsen the condition.
- Change into dry clothes immediately after swimming or getting wet.
- Refrain from using vaginal sprays, douches, and soaps that contain irritants.
- Avoid the consumption of spicy foods, caffeine, artificial sweeteners, and carbonated drinks.
- Do not wear body-fitting clothes such as tight jeans and trousers, and use cotton underwear.
- Frequently change sanitary napkins and tampons.
- Wash before and after sexual intercourse and use protection.
- Urinate after sex to flush out the microbes from the urethra and bladder.
- Take vitamin C in moderate amounts if you have kidney problems.
- Do not control your need to urinate.
- Keep yourself hydrated.
- Restrict alcohol intake and smoking.
- For women, wipe in a front-to-back motion after having a bowel movement or urination, and keep the genital area clean and dry.
Home Remedies for Dysuria
The following home remedies may help alleviate dysuria:
1. Increase Water Intake
Increasing the amount of water you drink through the day promotes frequent urination. This helps in flushing out infectious microbes and toxins from your body, thus relieving pain.
Also, dehydration can aggravate the condition. Drinking water at regular intervals prevents dehydration and also helps maintain body heat.
Water-based fruits and vegetables, smoothies, juices, soups, and broths can also be consumed as fluid sources to maintain optimum hydration levels in the body.
2. Consume Cranberry Juice and Vitamin C
Intake of ascorbic acid or vitamin C supplements is known to alleviate UTIs and works by making the urine more acidic. (2)
Cranberries have been utilized for the management of UTIs. They are 88% water and contain fructose, organic acids (such as salicylate), anthocyanidins, triterpenoids, catechins, flavonoids, and high levels of Vitamin C (200 mg/kg of berries).
Note: If you have kidney problems, refrain from using vitamin C supplements without your doctor’s recommendation. Excessive vitamin C can increase oxalate concentration in the urine and may lead to kidney stones.
3. Use Warm Compress
Applying a warm compress can help in alleviating bladder pressure and subsiding pain, giving a soothing effect. You may also use a heating pad in place of the compress.
How to use:
- Soak a fresh washcloth in warm water and wring out the excess water.
- Apply the compress on your lower abdomen for 5 minutes.
- Wait for some time and reapply.
Note: Keep changing the position of the compress to prevent your skin from burning. Do not use an extremely hot compress.
Some General Queries
How long does dysuria last?
The duration of dysuria depends on the cause. A UTI may subside in a few days on treatment. However, it can be challenging to determine the reason for the dysuria in some cases, leading to prolonged symptoms.
Is dysuria a disease?
Dysuria is a symptom of various medical problems, not a disease in itself.
What is the prognosis of dysuria?
Dysuria commonly occurs as a result of infections in the urethra, bladder, kidney, or vagina, which can be treated with antibiotics. Timely treatment prevents any long-term damage.
However, dysuria caused by sexually transmitted diseases may lead to scarring of the reproductive tract and infertility in women if not attended to immediately.
Does dysuria normally accompany hematuria?
The appearance of blood in the urine is medically termed as hematuria and results from improper filtering by the kidneys.
It may also be due to a problem in the urinary tract organs, such as the ureter and bladder, which causes blood cells to leak into the urine. Various medical conditions can lead to hematuria, which might be accompanied by dysuria.
An old study conducted in 1993 showed that dysuria and hematuria (coffee-brown or bright-red urine) might occur simultaneously with symptoms such as penile or periurethral (tissues around the urethra) pain, bladder spasm, and skin irritation, without any infectious causes. (4)
What can cause painful urination in pregnant women?
During pregnancy, women often notice an increase in the frequency of urination. While this is normal, experiencing pain while peeing may be indicative of diseases, including chlamydia, genital herpes, trichomoniasis, bacterial vaginosis, endometriosis, and urinary tract infection.
Can someone suffer from dysuria while menstruating?
Females with endometriosis may experience dysuria during menstruation. Endometriosis is an unusual growth of uterine tissue outside of the uterus.
It affects around 11% of women in the age group 15-44. It is prevalent among women in their 30s and 40s and creates issues in conceiving. (6)
Endometriosis is often accompanied by dysuria, urinary frequency, and hematuria, especially when the bladder is affected. (5)
Can dyspareunia and dysuria occur together?
Dyspareunia refers to painful sexual intercourse and can occur along with dysuria in some cases of atrophic vaginitis.
In atrophic vaginitis, the vaginal tissue becomes thin and dry due to a lack of discharge, leading to dyspareunia. If the vulva is involved, the patient may also experience dysuria and a burning sensation in the vulva.
Can dysuria and pyuria co-occur?
The urine may contain leukocytes or white blood cells (commonly known as pus) as a result of some health problems. This condition is medically known as pyuria and can turn the urine cloudy in appearance.
It is usually caused by a urinary tract infection and thus might be accompanied by dysuria.
When is dysuria more common?
Dysuria is prevalent in the summer season because of dehydration. Low consumption of water can lead to concentrated urine, which is highly acidic and may cause pain and burning.
Can dysuria have psychogenic causes?
Dysuria can result from psychogenic causes, such as hysteria, anxiety, and depression. It is important that the medical history of the patient is studied, and tests are done to eliminate other causes, following which appropriate therapy can be suggested for the psychogenic cause.
Complications Associated with Dysuria
Dysuria may lead to various short-term and long-term complications depending on its cause.
The short-term complications that can occur due to dysuria include:
- Acute renal failure
- Acute anemia from hematuria
- Emergent hospitalization
Dysuria can also lead to the following chronic problems:
- End-stage renal disease
- Urinary tract cancers
- Disability from recurrent infections
- Fatal systemic infection and sepsis
In some cases, UTIs may be recurrent and call for repetitive treatments, which can lead to antibiotic resistance, increasing the chances of hospitalization, morbidity, and mortality.
Risk Factors for Dysuria
The following factors may predispose you to dysuria:
- Ages between 24 and 54
- Physical activities such as cycling or horse riding
- Unprotected sexual intercourse
When to See a Doctor
It is recommended to seek medical help if you experience severe pain while urination, especially if it is accompanied by:
- Back pain
- Abdominal pain
- Abnormal urethral or vaginal discharge
- Blood in the urine
- Increased urinate frequency and a pressing need to pee
What you may ask your doctor:
- What could be the reason behind my problem?
- Do I have a urinary tract infection or any other ailment?
- What treatment can I follow?
- Will there be side effects from the treatment?
- When will it get cured?
What your doctor may ask you:
- Since when have you experienced pain while peeing?
- Does the pain stop with urination or continues?
- Do you have any discharge or drainage between urinations?
- Does your urine have an abnormal smell?
- Are you taking any medications?
- Does your urine have blood?
- Are you expecting a baby?
- Does your sexual partner have gonorrhea or chlamydia?
Pain or burning during urination is known as dysuria and may cause continuous urethral discomfort. The treatment depends on the reason behind the problem.
In rare cases, the cause can be a tumor. If a cancerous mass in the urinary tract is suspected in the primary diagnosis, a referral to a urologist (urinary tract specialist) is highly recommended. Further tests can help determine if the tumor is malignant, so proper treatment can be given.
In the case of cancer, the treatment depends on its type and severity, but generally includes surgery, chemotherapy, radiotherapy, or immune therapy.
Expert Answers (Q&A)
Answered by Dr. Daniel C. Edwards, DO (Urologist)
Dysuria, the feeling of burning or discomfort while urinating, can be due to issues originating in the bladder or urethra. The causes can be neurological, inflammatory, obstructive, or even cancerous.
The most common cause of dysuria in females is a urinary tract infection, whereas the most common cause in males is obstruction by an enlarged prostate.
Dysuria may also be caused by a bladder that squeezes too hard or too frequently, noninfectious inflammatory conditions, sexually transmitted diseases, stones in the bladder, scar tissue in the urethra, or, in some cases, cancer.
Dysuria is a symptom, not a diagnosis or disease. Dysuria may be a symptom of an STD and, therefore, must be evaluated by a physician.
Dietary changes alone will only address dysuria in some scenarios. It is important that patients with dysuria be evaluated by at least their primary care physician or by a urologist.
The duration of dysuria is dependent upon the cause. It could be transient or a chronic issue.
The most important thing to understand is that the most common causes of dysuria are benign and can be addressed by a primary care physician and/or urologist.
However, it is imperative that patients with dysuria be evaluated by a medical professional to rule out potentially devastating conditions, such as bladder cancer.
About Dr. Daniel C. Edwards, DO: Dr. Edwards is a urologist and practices in Southeastern Pennsylvania with a special interest in cancerous conditions that affect the kidneys, bladder, prostate, and genitalia.