Dysuria (Painful Urination): Causes, Symptoms, and Treatment

Dysuria, or painful urination, causes pain and burning when peeing.

If you’re affected by this condition, you might feel pain and stinging in the urethra, the tube urine passes through, as well as the genitals.

This condition is relatively common and happens when the lining of the urethra is irritated. When urine touches the inflamed area, it can cause pain and burning.

There are a variety of causes of dysuria, and treatment depends on the underlying cause of the condition.

In this article, I’ll discuss the symptoms of dysuria and outline some of its most common causes.

I’ll also talk about treatment options and when you should see a doctor or healthcare provider.

Symptoms of Painful Urination 

Usually, the primary symptoms of dysuria are pain, burning, and stinging when peeing. 

You might also experience:

• Discolored urine
• Bad-smelling urine
• Fever
• Irritability
• Urinating more often than usual
• Urgency when urinating
• Lower back pain

Causes of Dysuria

There are myriad causes of painful urination, including kidney stones, bladder infections, and more. 

Cystitis

Cystitis is inflammation of the bladder that can cause pain and discomfort.

It can be caused by infection, but it can also be caused by non-infectious conditions.

Usually, cystitis is a urinary tract infection (UTI), which is commonly called a bladder infection. 

Urinary tract infection (UTI)

Urinary tract infections happen when a bacterial infection moves up the urinary tract.

They can cause pain, burning, and stinging when you pee, and you may also have pain in your lower abdomen and a need to pee more often.

UTIs are more common in females.

You’re at a higher risk of UTIs if you wipe incorrectly after going to the bathroom (from back to front instead of front to back) and if you take baths instead of showers. 

Providers treat UTIs with a short course of antibiotics.

If symptoms do not go away after antibiotics, you should contact your doctor or provider.

Interstitial cystitis

Interstitial cystitis, also called painful bladder syndrome (PBS), can cause pain when peeing, a constant need to pee, pelvic pain, and pain in your lower abdomen. 

Doctors don’t know exactly what causes interstitial cystitis, but it is more common in women than men, and it is particularly prevalent in those over 30. 

If you have ongoing pain like that described here, a provider can run tests to figure out what’s causing it, and you might be prescribed antibiotics or other medication. 

Sexually transmitted infections (STIs)

Some STIs can cause dysuria, especially in males.

Chlamydia, gonorrhea, and trichomoniasis are all possible causes.

In addition to pain during urination, you might have discharge from your genitals.

If you think you might have an STI, you should contact your doctor or local sexual health clinic to get tested. You can treat STIs with antibiotics, antiviral medications, and creams.

Prostate infection

A urinary tract infection can cause prostatitis, which is inflammation and swelling of the prostate. 

There are two main types: chronic and acute.

The most common is chronic, which happens gradually, and your symptoms will ebb and flow over a number of months.

Acute, on the other hand, comes on suddenly and is severely painful.

This is far rarer and often causes a visit to the emergency room.

In addition to pain when urinating, prostatitis can cause lower back pain, abdominal pain, genital pain, and painful ejaculation.

You might need to pee often, not be able to pee, or have blood in your pee. If you have these symptoms, it’s a good idea to call your doctor or provider.

Kidney stones

Large amounts of salt and minerals in your urine can cause kidney stones.

Sometimes, these stones stay in the kidneys and don’t cause any problems; other times, they pass through your urinary tract and can be very painful. 

Kidney stones can make you pee more often, cause a burning feeling when urinating, and lead to blood in the urine. If you have kidney stones, you might also feel nauseous and ill.

In most cases, kidney stones will pass on their own.

A provider might prescribe pain medication and drugs like Tamsulosin (Flomax) that relax the ureter, making it easier for the kidney stones to pass through. In rare cases, you may need surgery.

Ovarian cysts

Ovarian cysts are fairly common for people born with vaginas, and they are usually harmless.

They can cause pain when peeing, a need to pee often, pelvic pain, pain during sex, and bloating.

A doctor or provider can diagnose ovarian cysts with an ultrasound scan.

If your provider is worried about your cyst(s), they’ll run additional tests. However, they are usually not a cause for concern.

Chemical sensitivity

Some products and chemicals can cause irritation, leading to pain when urinating.

Scented soaps, shaving foams, douches, feminine pads, tampons, and toilet paper can all potentially cause problems.

Vaginal infection or irritation

Vaginitis, also called vaginosis, is an infection in the vagina that can cause pain, irritation, and discomfort.

In addition to pain when urinating, it can also cause pain during sex, bleeding, and unusual discharge.

Medication

Certain medications, such as those used to treat bladder cancer, can cause pain when urinating.

They can also have other side effects, depending on the medication.

Bladder cancer

Bladder cancer is a cancer of the bladder cells. The most common early symptom is blood in the urine, but pain and burning when urinating can also occur.

Other signs of bladder cancer include lower back pain, frequent urination, weight loss, fatigue, and generally feeling unwell.

These symptoms are similar to other less serious conditions, so it is important to know that bladder cancer is an unlikely cause of dysuria.

If you have worrying symptoms, it is a good idea to call your provider.

Treatment

Treatment for painful urination depends on the underlying cause. 

The most common cause is a UTI, which doctors treat with a course of antibiotics.

Other infections, like STIs and prostate infections, can be resolved with antibiotics and other medications. 

If you have kidney stones, they will likely pass on their own. Your doctor or provider might recommend taking over-the-counter (OTC) pain relievers and drinking a lot of water to make the process easier.

However, if your kidney stones do not pass, you may need surgery.

Similarly, ovarian cysts usually don’t need medical intervention.

They typically don’t cause any issues, so your doctor will recommend waiting and keeping an eye on them. If they do cause problems, they can be removed with minimally-invasive laparoscopic (keyhole) surgery.

When To See a Medical Provider

Many cases of dysuria resolve on their own after a few days.

However, if your pain doesn’t go away, you should call your doctor or provider.

Contact a healthcare provider if you experience the following:

• Fever or chills
• Blood in your urine
• Pain for more than three days
• Drainage or discharge
• Rash
• Joint pain
• Back pain

A doctor can evaluate your symptoms and determine what’s causing the pain.

They will likely ask about your symptoms, how long they have been going on, and when the pain is better and worse. Additionally, they might run tests like a urinalysis, which is particularly useful in diagnosing UTIs.

Some causes of dysuria are harder to diagnose.

For example, there is no test to definitively diagnose interstitial cystitis.

If your provider thinks you have this, they will first rule out other possible conditions that could be causing your symptoms.

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