Painful urination is any pain or discomfort that results when a person urinates. This pain can occur by itself or it can be associated with other symptoms.
The urinary tract consists of several parts, each with a different function. The kidneys filter and remove waste products and water from the body and produce urine. Urine travels from the kidneys through two narrow tubes called ureters down to the bladder, where it is stored. When the bladder becomes full, it empties the urine through the urethra to the outside of the body.
Painful urination can range from mild discomfort or a burning sensation in the urinary tract to severe, intense pain. This pain may be acute, when it occurs suddenly, or chronic, when the pain lasts for a long period of time. Painful urination usually results from conditions that may be caused by infection, trauma, or something blocking the urinary tract.
There are many possible causes of painful urination. Some of these include:
When a person has painful urination, the healthcare provider will want more information. Questions may include the following:
Diagnosing the cause of painful urination depends on the symptoms. A medical history and a history of activity, trauma, or illness may help in diagnosing the cause of the pain. The healthcare provider will want to know when the pain occurs during urination. This may help pinpoint a diagnosis. A thorough physical exam may be necessary. Urine tests, such as a urinalysis and a urine culture, may be necessary to check for infection. Blood tests may be ordered if an infection is suspected throughout the body.
Several other tests that may be done include the following:
Preventing painful urination depends on the cause of the pain. Protecting the urinary tract from trauma may decrease the risk of pain. Seeking early care for possible infection may decrease the risk of further pain.
Avoiding irritating bubble bath solutions, wearing cotton-lined underwear, and avoiding tight-fitting clothes may reduce the pain that goes along with allergic reactions or genital irritation. Limiting caffeine intake and practicing safer sex may also reduce a person's risk of having painful urination. Many causes cannot be prevented.
Long-term effects of painful urination will depend on the underlying cause of the pain. Pain caused by a genital injury may heal without any long-term effects. A person with a history of chronic urinary tract infections may need low-dose antibiotics for a long period of time. Some injuries or infections may lead to permanent urinary tract damage or pain. A person who has a tumor in the urinary tract may require surgery and medications over a long period of time. A person with a cancerous tumor may be treated in some cases and may die in other cases.
Painful urination is not necessarily contagious and poses no risk to others. However, if the cause is an infection, such as a sexually transmitted disease, the infection may be contagious.
Treatment of painful urination depends on the underlying cause of the pain. When an injury occurs, the person should apply an ice pack off and on for the first 24 hours to reduce pain and swelling. Heat, such as in a warm sitz bath, may be recommended for some causes of painful urination. Antibiotics may be prescribed for infections. Medications to stop the growth of kidney stones may be prescribed, as well as medications to stops spasms caused by kidney stones or infection.
Other treatments will vary greatly depending on the cause of the pain. Those with cancer may need surgery, chemotherapy, or radiation therapy. Surgery may be needed for those who have kidney stones or damage to the urinary tract from an injury or recurrent infections.
Side effects to treatment depend on the treatment used. There are usually no side effects to ice packs or heat as long as they are not applied to the skin for long periods of time. There may be stomach upset, headache, or allergic reaction to antibiotics. Treatments that require surgery pose a risk of bleeding, infection, and allergic reaction to anesthesia.
If painful urination was caused by a urinary tract infection, a urinalysis may be done after the person finishes the full course of antibiotics. A person with minor pain and no other conditions may heal fine and may not need any further treatment. If a person had surgery, he or she may need to take it easy for a few days to a few weeks and may need follow-up care.
Monitoring painful urination is important. If the pain worsens or any other symptoms are present, a healthcare provider may need to monitor the person carefully. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eileen McLaughlin, RN, BSN
Reviewer:Gail Hendrickson, RN, BS
Professional Guide to Signs and Symptoms, Springhouse, 1997
Harrison's Principles of Internal Medicine, 1998, Fauci et al.