Painful Urination

Painful urination also referred to as dysuria, is the pain you can feel when urinating. Other similar abnormal feelings during urination can be burning sensation and stinging. In some cases, blood or blood clots might be mixed with urine. These symptoms can also occur at the end of urination or remain constant, regardless of urination, at the tip of the penis. In females, this continuous discomfort might increase in particular while sitting down. Painful urination is quite common and when it is significant, it occurs during the day and at night with a significant impact on the quality of life. Sexually transmitted diseases (STDs) are the leading causes.

Pain during urination in a child is usually a sign of lower urinary tract infection. Urinary tract infections (UTIs) are the second most common bacterial infection in children.

Causes of painful urination

In women, the leading cause of painful urination is cystitis, a bacterial infection of the bladder usually caused by a bacterium called E. Coli. In most cases, cystitis is no complicated and can be treated with a short antibiotic course. In more severe cases cystitis can be accompanied by blood in the urine or can spread up to the kidneys causing high fever, flank pain, chills, and prostration (pyelonephritis). In some cases, cystitis can be recurrent and adversely affect the quality of life. Vaginal thrush It is mostly harmless, but symptoms can develop if yeast numbers increase. About 75 per cent of women will have vaginal thrush in their lifetime. Other names for this infection are candidiasis or monilia. Symptoms can include vaginal itching or burning, a white discharge and stinging or burning while urinating 

In young adult men, the leading cause of painful and burning urination is urethritis and prostatitis. In most cases, this infection is sexually transmitted (gonorrhoea, chlamydia, mycoplasma, herpes) and requires immediate treatment. Having sex with multiple partners without using a condom is at high risk for sexually transmitted diseases.

In older people, the prostate enlargement is often associated with prostatitis.

A less common cause of burning or pain in the genital area is the chronic and intermittent bladder catheterization in patients with urinary retention.

Other reasons for pain while urination without infection:

  • Bladder Pain Syndrome; 
  • chronic no infective urethritis (Lichen sclerosus);
  • Certain foods are more likely to irritate your bladder. Some irritants to avoid include alcohol, caffeine, spicy foods, citrus fruits and juices, tomato products, and artificial sweeteners.
  • The use of aggressive soaps, laundry detergents, and toiletries ;
  • Dehydration, which makes the urine more concentrated. This can irritate the urethra and can make passing urine more painful;
  • Hungover: it might be associated with dysuria;
  • the menstrual period: painful urination is not common and might indicate some underlying diseases like endometriosis;
  • Febrile diseases like influenza and other virosis, through dehydration and urine concentration, can irritate the urethra and make the urination painful.
  • Painful urination could be related to kidney stones or stones in the ureter (the tube that connects the kidney to the bladder); in this case, it can be accompanied by frequent urination and pain in the lower back. This pain may also radiate to the groin;
  • An infection in the kidney can also cause back pain and frequent and painful urination and sometimes nausea and diarrhoea

Immediate after sex, painful urination might be due to trauma (especially after prolonged intercourse). Later on, could be symptoms of UTI (urethritis in male or cystitis in female) caused by sexual intercourse.

Treatment options for painful urination

The treatment of painful urination depends on the disease that is causing it. Since infectious diseases, sexual or not, are the most frequent causes, the treatment is usually antibiotics.

The correct treatment should be prescribed by the doctor, according to the type of infection. Wrong use of antibiotics might get it worse, get it chronic, or increase bacterial resistance.

Some food supplements like cranberry extracts, mannose, or probiotics might help the full recovery. Your doctor may prescribe medication to treat painful urination.

To avoid highly acidic foods, help the bladder heal. It is better to stick with a bland diet for several weeks while receiving medical treatment 

Prevention

Steer clear of scented laundry detergents and toiletries to reduce your risk of irritation. Use condoms during sexual activity to keep yourself safe from STIs. Modify your diet to eliminate food and drinks that irritate the bladder.


FAQ

Q: which STD (Sexual Transmitted Disease) causes painful urination?

A: All STDs causing urethritis and affecting the patients someday or a few weeks after intercourse.  Chlamydia, Gonorrhea, Herpes, Mycoplasma are STDs causing urethritis.

Q: How painful is urination with STDs or with UTI (Urinary Tract Infections)?

A: STDs or UTI are common causes of Urethritis. It usually starts as mild painful urination that does not go away even with the home remedies you have heard about or googled on the internet. Soon you might see some grade of urethral discharge possibly with drops of blood. The trend of the pain might progress until severe pain while urinating and between urinations as well.

Q: Is painful urination normal?

A: episodic, sporadic, and self-limiting painful urination is quite common. Dehydration makes your urine concentrated and acidic in the way that it hurts the normal urethra and makes you feel the pain. Some spicy food and alcohol may give you the same transitory pain because of changes in its acidity. Toiletries and soaps may irritate the terminal portion of the urethra and gives you pain while using it.

Q: is painful urination a sign of pregnancy or early pregnancy?

A: It is not a specific sign of pregnancy or early pregnancy. However, late pregnancy can increase the risk of having UTI like cystitis  (cystitis in pregnancy) because of bladder compression and abnormal voiding.

Q: painful urination a sign of HIV?

A: it is not a specific sign of HIV in only positive patients. However, in advanced stages of the disease, the immune system fails to prevent infections like urethritis, that's a cause of painful urination.    

Q: is painful urination always sign of UTI (Urinary Tract Infection)?

A: it is not. Bladder pain syndrome, a kind of chronic non-bacterial interstitial cystitis and Balanitis Xerotica Obliterans (Lichen Sclerosus) are rare causes of non-infective painful urination. Moreover, episodic, sporadic, and self-limiting painful urination is quite common. Dehydration makes your urine concentrated and acidic in the way that it hurts the normal urethra and makes you feel the pain. Some spicy food and alcohol may give you the same transitory pain because of changes in its acidity. Toiletries and soaps may irritate the terminal portion of the urethra and gives you pain while using it.

Q: is painful urination sign of dehydration?

A: yes, it is. Dehydration makes your urine concentrated and acidic in the way that it hurts the normal urethra and makes you feel the pain.

Q: will painful urination go away?

A: if the cause of painful urination is an infection or a Sexual Transmitted Disease (STD), it will not go away easily. It will a progressive and worsening trend that makes you searching for medical advice. On the contrary, painful urination due to simple irritation because of getting dehydrated, drinking alcohol, eating spicy food, and toiletries, it will easily go away after one or a couple of days.

Q: Why painful urination?

A: painful urination happens when there is an inflammation/infection or simply an irritation in the urethra (the channel that carries urine out of the bladder), in the prostate (it is crossed inside by the urethra) or in the bladder. Inflammed or irritated bladder, prostate, or urethra are more sensitive to the normal urine acidity and the contact between urine and the irritated organs generates pain.

Q: what causes painful urination in males?

A: The leading causes of painful urination in males are Sexual Transmitted Diseases or Infections (STD or STI). During intercourse, bacteria can contaminate the terminal part of the urethra, starting an infection (urethritis).

Q: what causes painful urination in females?

A: The leading causes of painful urination in females are the non-complicated lower urinary tract infections (acute cystitis) that can happen immediately after sexual intercourse but are not caused by the common bacteria seen in STD/STI. The 85% of these infections are due to E Coli, a common bacteria which is normally found in the intestine of normal people.

Q: what causes painful urination after sexual intercourse?

A: In males, painful urination immediately after sex is commonly due to the contact of the terminal part of the urethra with the acidic vaginal secretions in particular after prolonged intercourse. In women, it may be due to trauma related to long intercourse. In these cases, painful urination is only transitory and it solves after a few urinations. If the pain starts after a few days, it can be due to infection or STD.

Q: can constipation cause painful urination?

A: it is not common that constipation causes painful urination. However, An over-full bowel (due to constipation) can press on the bladder, reducing the amount of urine it can hold or making you feel like to need to pass urine urgently. So, urgent urination is more common than painful urination in constipated patients.

Q: can be painful urination without discharge?

A: yes it could be, especially when the painful urination is not due to infection but only irritation (dehydration, food, alcohol intake, toiletries).

Q: can diabetes cause painful urination?

A: People with diabetes may experience bladder problems such as the overactive bladder, poor control of sphincter muscles that surround the urethra, urine retention, and urinary tract infections. In cases of infections, a diabetic patient may experience painful urination. 

Q: what causes painful urination during the period?

A: painful urination is not common during the period like frequent and urgent urination. If it is predominant, it might indicate some underlying diseases like endometriosis.

Q: can ovarian cyst cause painful urination?

A: it is not so common; a large ovarian cyst can cause abdominal discomfort. If a large cyst presses on your bladder, you may feel the need to urinate more frequently instead of with pain, because bladder capacity is reduced.