Dysuria (Painful Urination): Causes, Symptoms, & Treatments

Dysuria (pain with urination or “it hurts while peeing”) can have many potential causes, ranging from urinary tract infections to sexually transmitted diseases. Most of the causes of dysuria are treatable. Please continue reading to find out more.

Understanding Dysuria

Dysuria is the medical term for pain or discomfort when you urinate. Dysuria is not a medical condition or a diagnosis. It is a symptom of an underlying health problem. 

Dysuria is different from urinary frequency (needing to pee often) and urinary urgency (needing to pee urgently even when your bladder isn’t full). However, dysuria and these associated symptoms often occur together.

What Is The Difference Between Dysuria and UTI?

Dysuria (painful urination) is a symptom, whereas a urinary tract infection (UTI) is a condition. UTI is a common cause of dysuria, but other medical conditions besides UTIs can also cause dysuria. People with a UTI often have dysuria plus other lower urinary tract symptoms.

Is Dysuria an STD?

Dysuria can be a symptom of an STD (sexually transmitted disease) or STI (sexually transmitted infection). As noted, painful urination (dysuria) is a symptom and not a condition by itself. 

What Is The Main Cause of Dysuria?

The main cause of dysuria is urinary tract infections (UTIs). Common sensations associated with dysuria from a urinary tract infection include burning, stinging, or itching of the urethra (the tube that carries urine outside the body) or the urethral meatus (opening) during urination. 

UTI-related dysuria is most often a burning sensation that occurs at the start of urination. However, the pain can sometimes occur after urination. 

Women may feel pain internally, but it can also be an external pain from irritation of the surrounding skin. Pelvic or suprapubic pain just above the pubic bone is common in women with UTIs. In men with UTIs, the pain in the penis can persist after urination. Check out our blog, “Can A UTI Be Transmitted From Woman To Man?”

What Are The Most Common Causes of Dysuria?

Some of the medical conditions in which dysuria is a symptom are described below.

Urinary Tract Infection

Urinary tract infections are the most common cause of dysuria. Cystitis (bladder infection) is the most common lower urinary tract infection. Other types of UTIs include urethritis (urethra infections) and pyelonephritis (kidney infections). 

Besides dysuria, other symptoms of a UTI may include urinary frequency, bloody or cloudy urine, foul-smelling urine, fever, and back pain or flank pain. 

Sexually Transmitted Infections

Painful urination can be a symptom of a sexually transmitted infection such as Chlamydia trachomatis, Neisseria gonorrhea, human papillomavirus (HPV), herpes simplex virus (genital herpes), trichomoniasis, genital warts, or syphilis. Additional symptoms may include redness, itching, blisters or lumps in the genital area, and an unusual vaginal or penile discharge.

Vaginal Infection

Vaginitis is an inflammation of the vagina. It can be a bacterial infection, fungal infection, or protozoan infection such as trichomoniasis. In addition to vaginal itching, irritation, and abnormal vaginal discharge, these infections can cause painful urination and pain during sex.

Prostatitis

Prostatitis is an inflammation of the prostate gland in men. It can be acute prostatitis, which comes on suddenly with severe symptoms and requires emergency treatment. It can also be chronic bacterial prostatitis, which is the more common type, in which the symptoms last for several months and tend to come and go. Prostatitis can cause you to experience painful urination and other symptoms such as lower back pain, pain around the penis and testicles, frequent urination, difficulty urinating, erectile dysfunction, fever, and malaise.

Note: Benign prostatic hyperplasia (non-cancerous enlargement of the prostate gland) can cause urinary symptoms such as a weak urinary stream, trouble starting the stream, dribbling, and nocturia (urinary frequency at night), but BPH does not usually cause dysuria (painful urination). 

Kidney Stones

Sometimes, a kidney stone gets lodged in a narrow part of the urinary tract, for example, the ureter. The ureter is a thin tube through which urine passes from from the kidneys to the bladder. The resulting urinary obstruction can cause painful urination. Kidney stones can also increase the risk of recurrent urinary tract infections.

Dysuria caused by renal calculi (kidney stones) may be accompanied by flank pain, back pain, abdominal pain, blood in urine, frequent urination, difficulty urinating, cloudy urine, foul-smelling urine, fever, chills, nausea, and vomiting.

Interstitial Cystitis

Interstitial cystitis refers to bladder inflammation. It is part of a broader group of conditions called bladder pain syndrome or chronic pelvic pain conditions. Signs and symptoms include chronic pelvic pain, painful urination, urgency, frequency, pain when the bladder is full and relief when you empty it, and dyspareunia (pain during sexual intercourse).

Urethral Syndrome

The urethra is the tube that carries urine from the urinary bladder to the outside of the body. Urethral syndrome is a condition that can occur due to hormonal imbalance, injuries, or sexually transmitted infections. It is associated with urethral irritation, urethral discharge, painful urination, urinary frequency, and difficulty with urination. 

Other conditions, such as urethral strictures (narrowing), can cause a slow urinary stream, frequency, urgency, and pain with urination.

Bladder Cancer

People with bladder cancer may have signs and symptoms such as painful urination, frequent urination, back pain, and hematuria (blood in urine, which makes the urine appear bright red or cola-colored).

Urinary Tract Irritation

Hygiene products such as soaps, douches, bubble baths, scented toilet paper, and contraceptive gels and foams can irritate the urethra and cause painful urination. Other symptoms of urinary tract irritation may include redness, swelling, and itching of the skin in the genital area.

When To Seek Medical Advice for Dysuria

You should always contact your health care professional for dysuria (burning sensation, discomfort, or pain with urination) to find out the cause. Your provider can determine if this symptom is from a urinary tract infection or some other medical condition. The sooner you see your doctor, the sooner you can get a diagnosis and appropriate treatment for dysuria relief.

Diagnostic Tests: How Do Doctors Diagnose the Cause of Painful Urination?

If you have painful urination and/or other lower urinary tract symptoms, your doctor can make a diagnosis based on your medical history, physical examination, urine cytology, urine culture, and laboratory tests. They may also order imaging tests (ultrasound, CT scan), for example, to find the location of a kidney stone.

Based on the findings, they will prescribe the appropriate treatment for relief from dysuria. For example, if culture and sensitivity testing on your urine sample shows a urinary tract infection (UTI), your healthcare provider will prescribe the appropriate antibiotic therapy. If you get frequent urinary tract infections, your provider may recommend lifestyle changes and/or prescribe long-term treatment with low-dose antibiotics for prevention.

Dysuria Treatment Options

Prescription Drugs for Dysuria

Antibiotics

The treatment for painful urination (dysuria) depends on the underlying cause. For example, your doctor will prescribe antibiotics to treat painful urination caused by a urinary tract infection (UTI). 

For sexually active patients who have recurrent urinary tract infections following sexual activity, healthcare providers may recommend antibiotic prophylaxis. In these cases,  antibiotics are to be taken on an as-needed basis soon after sexual activity by the individual who develops frequent urinary tract infections following sexual activity. 

Similarly, antibiotic therapy can be used to cure infections caused by some sexually transmitted organisms. Intravenous antibiotics may be needed to treat severe infections requiring hospitalization.

Other Prescription Drugs

In menopausal women, dysuria and other urinary symptoms can be due to atrophic vaginitis (thinning of the tissues). Treatment in this case will consist of topical estrogen and/or hormone replacement therapy.

Male patients may have prostatitis treated with antibiotics for infection, alpha-blockers for urinary symptoms, pain medications to reduce discomfort, and prostatic massage for chronic prostatitis.

Treatments for Other Medical Conditions

If you have a chronic condition such as neurogenic bladder or diabetes mellitus, you are at a higher risk of urinary tract infections (UTIs), bladder issues, and sexual dysfunction. In this case, treatment for dysuria will consist of lifestyle changes and medications to keep blood sugar levels under control or treat neurogenic bladder.

Home Remedies and Over-The-Counter Medicines for Dysuria

Over-the-counter medications for dysuria include pain relievers such as acetaminophen, ibuprofen, and naproxen. 

If your dysuria is from a UTI, you can take phenazopyridine (AZO, Uristat) for relief from burning and pain with urination. However, you should not take phenazopyridine for more than 2 days without talking to your doctor. Note: This medicine can turn your urine red-orange. This side effect is temporary and expected.

It’s important to see your health care provider and find out the underlying cause of dysuria before treating it with home remedies. As mentioned above, many medical conditions can cause dysuria. For example, dysuria can be a symptom of UTI but also a yeast infection - one is a bacterial infection, and the other is a fungal infection, and they have different treatments. Your doctor can make a proper diagnosis and prescribe an antibiotic for a UTI or an antifungal medicine for a yeast infection.

What Happens If Dysuria is Left Untreated?

Sometimes, painful urination is a sign of a serious underlying condition, such as bladder cancer. Leaving it untreated can delay diagnosis and reduce the chances of successful treatment or cure. 

Dysuria is commonly a symptom of a urinary tract infection (UTI). Recurrent urinary tract infections or complicated urinary tract infections can lead to serious health issues such as kidney abscess formation, bacteremia, sepsis, and acute kidney failure. Untreated sexually transmitted diseases can lead to complications such as pelvic inflammatory disease (PID).

Dysuria Prevention Tips

Urinary tract infections (UTIs) are the main cause of dysuria. To lower your risk of developing UTIs:

• Stay well hydrated (drink 2-3 liters of water every day).

• Urinate regularly (don’t hold urine for too long).

• Wipe from front to back after using the bathroom, especially after a bowel movement, to prevent bacteria from the anus from spreading to the vagina and urethra.

• Empty your bladder before and after sexual activity.

• Cleanse your genital and anal areas before and after sexual activity.

• Wear breathable (cotton) underwear and avoid tight-fitting clothes.

• Avoid using douches, powders, scented soaps, or other feminine hygiene products in your genital area.

• Avoid using spermicide-containing condoms or diaphragms.

• Avoid hot tubs and bubble baths.