When You Have Painful Urination and Burning (Dysuria)

Painful urination with burning is also known as dysuria

Girl in pain on the toilet
Getty Images/Peter Dazeley

Painful urination with burning, also known as dysuria, is most often felt in the tube that carries urine out of your bladder (called the urethra) or the area surrounding your genitals (called the perineum).

Common Causes of Dysuria

Painful urination with a burning sensation is usually a sign of a urinary tract infection, irritation, or inflammation of the bladder, urethra, or prostate. In women, it is most likely a urinary tract infection.

If you feel severe pain just as you stop urinating, your bladder is probably the source of the problem. Men are less likely to get urinary tract infections overall, but infection or inflammation of the prostate or urethra can cause painful urination.

Other Causes of Painful Urination

In women, candidal dermatitis or vaginitis, vulvitis, and interstitial cystitis (bladder infection) may be causing the painful urination with burning. Urinary retention and radiation cystitis also can result in painful urination with burning.

Other common medical conditions and external causes of painful urination include bladder stones; chlamydia; drugs, such as those used in cancer treatment, that have bladder irritation as a side effect; genital herpes; gonorrhea; having a recent urinary tract procedure performed, including use of urologic instruments for testing or treatment; kidney infection; kidney stones; other sexually transmitted diseases; soaps, perfumes and other personal care products; and urethral stricture (narrowing of the urethra).

When to See a Doctor

Make an appointment to see your doctor if:

  • Your painful urination persists
  • You have drainage or discharge from your penis or vagina
  • You see blood in your urine
  • You have a fever
  • You have back pain or pain in your side (flank pain)
  • You pass a kidney or bladder (urinary tract) stone

Diagnosing the Cause of Dysuria

Your doctor will most often be able to diagnose the cause of your painful, burning urination when you describe your physical symptoms and submit a urine sample for testing.

For female patients, the doctor may also swab the lining of the vagina or the urethra to check for signs of infection.

At your visit, you will also likely be asked to share your medical history, including information about conditions you may have, such as diabetes mellitus or immunodeficiency disorders. You may also need to share your sexual history to determine if a sexually transmitted disease (STD) is causing your pain. Tests for STDs may also be required.

The urine and/or swab sample your doctors takes will be analyzed for white blood cells, red blood cells, or foreign chemicals. White blood cells usually mean you have a bacterial infection. A urine culture, which takes about two days for final results, will show which bacteria are causing the infection.  It also helps the physician understand which antibiotics will help treat the bacteria.

If your urine sample shows no sign of infection, you may undergo additional tests to look at the bladder or prostate.

Sources:

Cleveland Clinic. Painful urination. https://my.clevelandclinic.org/health/diseases_conditions/hic-painful-urination

McAninch JW. Symptoms of disorders of the genitourinary tract. In: Tanagho EA, McAninch JW (eds) Smith’s General Urology. 17th ed. New York: McGraw Hill, 2008.

Mayo Clinic. Painful urination. http://www.mayoclinic.org/symptoms/painful-urination/basics/definition/sym-20050772

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