Symptoms and Signs of Symptoms and Signs: Painful Urination (Dysuria)

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Medically Reviewed on 4/14/2022

Doctor's Notes on Symptoms and Signs: Painful Urination (Dysuria)

Painful urination (dysuria) is a symptom that something is irritating the urinary tract; in most instances, it indicates a person has a urinary tract infection. The irritation is described as a burning sensation. Other signs and symptoms that may accompany painful urination include

  • a feeling you need to urinate frequently (urinary urgency),
  • blood in the urine,
  • cloudy urine,
  • dark urine, and
  • sometimes pain in the lower abdomen.

If infected with a sexually transmitted disease (STDs) also termed STIs, women can have a vaginal discharge and men can have a penile discharge.

Although infection of the urinary tract is frequently the cause of dysuria, there are other possible causes. Other causes of painful urination may include trauma to the urinary tract (blunt or stabbing trauma, catheter placement), enlarged prostate, urethral stricture, frequent douching, vaginal dryness, cancers, and medical problems like diabetes and immunosuppression.

What Are the Treatments of Painful Urination (Dysuria)?

There are a number of different causes of dysuria, so an accurate diagnosis by your doctor is important before treatment is begun. Your doctor may need to run diagnostic tests on the urine. The two most common reasons for dysuria are infection-related: urinary tract infections and STIs. Their treatments are focused on in this section:

In general, treatments for STIs are based on the cause of the disease; the following presents the type of drug treatment with an example or two. The list is not all-inclusive and the reader is urged to look up the possible treatments for specific STIs:

  • STIs
    • Viral causes: antivirals like acyclovir or antiretrovirals like a HIV combination drug therapy
    • Bacterial causes: antibiotics like penicillin or doxycycline
    • Fungal causes: antifungals like clotrimazole or miconazole
    • Protozoan causes: nitroimidazoles like metronidazole or tinidazole
    • Parasite causes: nitroimidazoles like metronidazole or tinidazole or an insecticide like permethrin

This article focused on the most usual treatments for the most usual causes of dysuria; your doctor may find other less frequent causes that need different treatments.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.