The sensation of pain or burning during or immediately following urination is medically known as dysuria. This discomfort ranges from a mild stinging to an intense, sharp pain, signaling irritation or inflammation within the urinary tract. Dysuria is common in both men and women of all ages, especially women. Although the experience is unpleasant, the symptom is often treatable once the underlying cause is identified.
Bacterial and Viral Infections
The most frequent cause of dysuria is an infection, where bacteria or viruses irritate the lining of the urinary system. A Urinary Tract Infection (UTI) occurs when bacteria, most commonly Escherichia coli, ascend the urethra and colonize the bladder, a condition called cystitis. The resulting inflammation causes the characteristic burning sensation when urine passes over the tissue. UTIs are often accompanied by the need to urinate more often than usual, a strong, sudden urge to go, and urine that appears cloudy or has a foul odor.
STIs are another major infectious cause of dysuria, particularly in sexually active individuals. Bacterial STIs like chlamydia and gonorrhea cause urethritis, or inflammation of the urethra. This irritation leads to dysuria, which may include an abnormal discharge. Viral infections, such as genital herpes, cause painful urination when acidic urine flows over open lesions on the genital or perineal area.
Non-Infectious Causes
Dysuria can also arise from irritations or physical obstructions not caused by pathogens. Chemical or external irritants can inflame the sensitive skin around the external opening of the urethra.
Chemical Irritants
Products such as fragranced soaps, bubble baths, feminine hygiene sprays, or certain laundry detergents can trigger contact dermatitis. This results in a stinging pain when urine touches the irritated area. Urethritis, or inflammation of the urethra, can also occur without infection due to irritation from sexual activity or a recent urological procedure.
Physical Obstructions
Physical obstructions within the urinary tract can cause significant pain. Kidney stones are hardened deposits that form in the kidneys and migrate into the ureter or bladder. As a stone passes down the narrow tract, it causes sharp pain, often radiating to the side or back, and irritates the lining, leading to dysuria. In women, localized inflammation like vaginitis, often due to a change in vaginal pH, can cause external discomfort during urination.
When to Seek Medical Attention
While the immediate discomfort of dysuria is the main concern, several accompanying symptoms warrant prompt medical evaluation.
Warning Signs
If the burning sensation is accompanied by a fever or chills, pain in the back or flank area, or persistent nausea and vomiting, it may indicate that an infection has spread to the kidneys, a more serious condition known as pyelonephritis. The presence of blood in the urine, which may appear pink, red, or brown, or an inability to urinate also requires immediate attention.
Diagnosis and Treatment
Until a medical professional can be seen, temporary relief measures include increasing fluid intake to dilute the urine, which may reduce the burning sensation. Avoiding bladder irritants, such as caffeine, alcohol, and spicy or acidic foods, can also help minimize irritation. Self-treatment is not a substitute for professional diagnosis, as the causes of dysuria require specific treatments.
A doctor’s visit typically begins with a medical history and physical examination. The most common diagnostic test is a urinalysis, where a clean-catch urine sample is examined for signs of inflammation, such as white blood cells, or the presence of blood. If an infection is suspected, a urine culture may be ordered to identify the exact type of bacteria present. This identification ensures the correct antibiotic is prescribed.