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

Key Takeaways

Dysuria, characterized by pain during urination, can result from various conditions, including urinary tract infections, sexually transmitted infections, vaginal infections, prostatitis, kidney stones, interstitial cystitis, urethral syndrome, bladder cancer, and urinary tract irritation.
Symptoms accompanying dysuria vary, including urinary frequency, bloody or cloudy urine, genital discomfort, back pain, and additional signs related to specific underlying causes.
Doctors diagnose dysuria through medical history, physical exams, urine cultures, laboratory tests, and imaging. Treatment depends on the underlying cause, with antibiotics prescribed for infections, hormone therapy for menopausal women, and lifestyle changes for chronic conditions like diabetes.

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.

What is the most common cause of dysuria?

Dysuria is pain and/or itching, stinging, or burning of the urethra or urethral meatus (opening) with urination. It can occur due to many different causes, some of which are described below.

Urinary tract infection

Urinary tract infections are one of the most common causes of dysuria. Other lower urinary tract symptoms of a UTI can 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), trichomoniasis, genital herpes, 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, vaginal infections can cause you to experience painful urination and pain during sex.

Prostatitis

Prostatitis is an inflammation of the prostate gland in male patients. 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 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 (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

If a kidney stone gets lodged in a narrow part of the urinary tract, for example, the ureter (a thin tube that carries urine from the kidneys to the bladder), then the resulting urinary obstruction can cause painful urination. Dysuria can 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, urinary urgency, urinary 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 outside 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.

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.

Is dysuria an STD?

Dysuria can be a symptom of an STD (sexually transmitted disease). Painful urination (dysuria) is a symptom and not a condition by itself.

How do doctors diagnose the cause of painful urination?

If you have painful urination and/or other urinary symptoms, you should make an appointment to see your doctor. Your provider can make a proper diagnosis based on your medical history, physical examination, urine cultures, laboratory tests, and imaging tests. 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.

How do I get rid of dysuria?

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). If you have recurrent urinary tract infections, your healthcare provider may recommend antibiotic prophylaxis (for example, antibiotics after sex in sexually active patients who develop urinary tract infections following sexual activity). They may also recommend continuous low-dose antibiotic treatment.

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

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

If you have a chronic condition such as 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.

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 lower the chances of successful treatment or cure.

Dysuria is commonly a symptom of a urinary tract infection (UTI). Frequent 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.

Main Takeaway

Dysuria can be a symptom of many different conditions, many of which are easily treatable. Dysuria symptoms should not be ignored. If you are experiencing painful urination, see your doctor for a proper diagnosis and treatment.

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