Symptoms and Signs: Painful Urination (Dysuria)

Painful urination is medically known as dysuria. It can occur in both men and women and is often caused by an infection of the urinary tract (UTI). A bacterial infection of the bladder or urethra is the most common cause of UTI. Other causes of painful urination are sexually-transmitted diseases like gonorrhea or chlamydia.

Painful urination is often described as a sensation of burning. Other symptoms of a UTI that can accompany painful urination include feeling the need to urinate frequently (known as urinary urgency), blood in the urine (hematuria), cloudy urine, dark urine, and pain in the lower abdomen or pelvis. If a sexually-transmitted infection is the cause, other associated symptoms can include abnormal vaginal discharge or discharge from the penis.

A burning sensation with urination can be caused by infectious (including sexually transmitted infections, or STDs such as chlamydia and gonorrhea) and noninfectious conditions, but it is most commonly due to bacterial infection of the urinary tract affecting the bladder.

• 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, accounting for a significant percentage of visits to a primary-care doctor.
• 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.

• Blood in urine
• Cloudy urine
• Dark urine

Infection of the urinary tract (urethra, bladder, or kidneys) is the most common cause of dysuria. The most common type of infections is cystitis (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, such as vaginal dryness
• Neurologic conditions: any nerve conditions that cause difficulty with bladder emptying
• Cancer: urethra, bladder, prostate, vaginal/vulvar, or penile cancer
• Medical conditions: diabetes mellitus and other chronic conditions that suppress the immune system