Pain During Urination

Overview

Pain during urination, known medically as dysuria, is a burning, stinging, or aching sensation felt while passing urine. The discomfort may be felt in the urethra (the tube urine flows through), the bladder area, or around the genitals. It is one of the most common urinary symptoms and a frequent reason people seek medical care.

By far the most common cause is a urinary tract infection (UTI), but painful urination can also result from irritation, inflammation, sexually transmitted infections, or other conditions affecting the bladder, urethra, or surrounding tissues. The cause is often suggested by the accompanying symptoms, such as where the pain is felt, whether it occurs at the start or end of urination, and whether there is fever, discharge, or blood. Most causes respond well to treatment, but some, such as a kidney infection, need prompt care to prevent complications.

Common Causes

Painful urination has several possible causes:

• Urinary tract infection (UTI): A bladder or urethra infection is the most common cause, often with frequent, urgent urination and cloudy urine.
• Kidney infection: A more serious infection that adds fever, chills, and back or flank pain.
• Sexually transmitted infections: Such as chlamydia, gonorrhea, herpes, and trichomoniasis.
• Vaginal infections or irritation: Yeast infections and bacterial vaginosis can cause burning that feels like painful urination.
• Irritation: From soaps, spermicides, scented products, or certain hygiene practices.
• Prostate problems: In men, prostatitis or prostate enlargement can cause painful urination.
• Other causes: Bladder inflammation (interstitial cystitis), kidney stones, and, rarely, bladder cancer.

Associated Symptoms

The symptoms accompanying painful urination help identify the cause and how urgent it is. You may notice:

• A frequent or urgent need to urinate
• Passing only small amounts of urine
• Cloudy, dark, bloody, or strong-smelling urine
• Pain in the lower abdomen or pelvis
• Fever, chills, nausea, or back or side (flank) pain (which may signal a kidney infection)
• Genital discharge, sores, or itching (which may suggest an STI or vaginal infection)
• Difficulty starting urination or a weak stream (in men, possibly prostate-related)

Painful urination with fever, back pain, or vomiting suggests a kidney infection and needs prompt care.

Diagnosis & Evaluation

A clinician identifies the cause through history and testing. Evaluation may include:

• Urine test (urinalysis) and culture: To detect infection and identify the responsible bacteria.
• Examination: Of the abdomen and, when relevant, a pelvic or genital examination.
• Tests for sexually transmitted infections: Based on history and findings.
• Imaging: Ultrasound or other scans if kidney stones, repeated infections, or structural problems are suspected.
• Prostate assessment: In men when prostate problems are a possibility.

Treatment & Management

Treatment is directed at the underlying cause.

• Antibiotics: For urinary tract infections, kidney infections, and many sexually transmitted infections.
• Antifungal treatment: For yeast infections causing burning.
• Removing irritants: Stopping scented products, spermicides, or harsh soaps.
• Pain relief and fluids: Drinking water and using pain relievers can ease discomfort while treatment takes effect; a clinician may prescribe a medication that numbs the urinary tract for a few days.
• Treating prostate or bladder conditions: Specific treatment for prostatitis, interstitial cystitis, or kidney stones.

Complete the full course of any prescribed antibiotics even if symptoms improve quickly, and follow up if the discomfort does not settle, since the cause may need to be reconsidered.

Self-Care & Prevention

• Drink plenty of fluids to help flush the urinary tract
• Urinate when you need to rather than holding it, and empty your bladder after sex
• Wipe front to back to reduce the spread of bacteria
• Avoid douches and scented products in the genital area
• Wear breathable cotton underwear
• Practice safer sex to reduce sexually transmitted infections

When to See a Doctor

See a doctor if you have painful urination, especially if it lasts more than a day, keeps returning, or comes with other urinary symptoms. Seek prompt or urgent care if you have:

• Fever, chills, nausea, or vomiting
• Pain in your back or side (flank pain)
• Blood in your urine
• Painful urination during pregnancy
• Genital discharge or sores
• Inability to urinate or severe pelvic pain

Painful urination with fever and back pain may indicate a kidney infection, which can become serious and needs timely treatment.

Related Topics

Frequently Asked Questions

References

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Bladder Infection (Urinary Tract Infection).
2. Mayo Clinic. Painful urination (dysuria).
3. Centers for Disease Control and Prevention (CDC). Sexually Transmitted Infections.
4. MedlinePlus, U.S. National Library of Medicine. Painful urination.