Painful urination (dysuria) is when you feel pain, discomfort, or burning when you urinate. The discomfort may be felt where urine passes out of the body. It may also be felt inside the body. This could include pain in the bladder, prostate (for men), or behind the pubic bone. Sometimes it can be a sign of an infection or other health problem.

Path to Improved Health

There are several conditions that can cause painful urination. The most common is a urinary tract infection (UTI). The urinary tract consists of the kidneys, bladder, and urethra. The urethra is the tube that carries urine out of the body. Bacteria can build in the tract when waste isn’t removed or if the bladder isn’t emptied correctly. This causes an infection. Swelling and irritation from the infection can make urination uncomfortable.

Sometimes painful urination can occur even if you don’t have a UTI. Other causes include:

• Certain medicines, like some used in cancer chemotherapy, may inflame the bladder.
• Something pressing against the bladder.This could be an ovarian cyst or a kidney stone stuck near the entrance to the bladder.
• Vaginal infection or irritation
• Sensitivity to chemicals in products.Douches, vaginal lubricants, soaps, scented toilet paper, or contraceptive foams or sponges may contain chemicals that cause irritation.
• Sexually transmitted infections.Gonorrhea, chlamydia, or herpes can cause urination to be painful for some people.
• Prostate infection

Things to Consider

Sometimes painful urination comes and goes on its own. Other times it is the sign of a problem. If you have any of the following symptoms along with painful urination, call your doctor:

• Drainage or discharge from your penis or vagina
• Blood in the urine
• Cloudy or foul-smelling urine
• Fever
• Pain that lasts more than 1 day
• Pain in your back or side (flank pain)

Also call your doctor if you are pregnant and are experiencing painful urination.

Painful urination can be a symptom of a more serious problem. Be sure to tell your doctor:

• About your symptoms and how long you’ve had them
• About any medical conditions you have, such as diabetes  or AIDS. These conditions could affect your body’s response to infection.
• About any known abnormality in your urinary tract
• If you are or might be pregnant
• If you’ve had any procedures or surgeries on your urinary tract
• If you were recently hospitalized (less than 1 month ago) or stayed in a nursing home
• If you’re had repeated UTIs
• If you’ve tried any over-the-counter medicines for your pain

If your doctor thinks you have a UTI, they will do a urinalysis. This tests your urine to look for infection. They may also order an ultrasound of your kidneys or bladder. This can help find sources of pain, including kidney stones.

Your doctor might think your pain is from vaginal inflammation. If so, they may wipe the lining of your vagina with a swab to collect mucus. The mucus will be looked at under a microscope. This will test for yeast or other organisms. Your doctor might think your pain is from an infection in your urethra. They may swab it to test for bacteria. If an infection can’t be found, they may suggest other tests.

Questions to Ask Your Doctor

• What is causing my discomfort?
• Is it a UTI or other infection?
• What is the treatment?
• Are there any side effects to the treatment?
• How soon will my symptoms get better?

Resources

American Family Physician: Painful Urination

National Institutes of Health, Medline Plus: Urination – painful

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What is a urinary tract infection?

A urinary tract infection (UTI) affects the kidneys, bladder, and urethra. Infection occurs when bacteria builds in the urinary tract when waste isn’t removed or the bladder isn’t emptied. When the bladder is involved in the infection, it is called cystitis. If the kidneys are involved, it is a more serious condition called pyelonephritis.

In general, UTIs are more common in girls. They can occur more often when children are potty training. Boys who have not been circumcised by the age of 1 are at risk of UTIs as well. Kids who have vesicoureteral reflux (VUR) may get UTIs more often. VUR is a condition in which urine can flow back into the urinary tract. VUR typically is present at birth.

Path to improved health

The sooner you detect a UTI, the quicker treatment can begin. It is important to know the symptoms. Common UTI symptoms include:

• Burning feeling or pain when you urinate
• Feeling like you need to urinate more often than usual
• Feeling the urge to urinate but not being able to
• Stomach pain
• Low back pain

Your child may not be able to communicate these symptoms. You should look for the following warning signs:

• Cloudy, dark, smelly, or bloody urine
• Fever or chills
• Vomiting
• Diarrhea
• Fussiness
• Poor appetite or less active
• Going through more diapers than usual
• Wetting clothes even though they are potty trained

Contact your doctor right away if you think your child has a UTI. The doctor will review symptoms and do a physical exam. The doctor also will do a urine test (urinalysis) to confirm the diagnosis. Getting a sample of urine can be hard in young children. There are several ways a doctor can collect urine.

• Catheterized specimen urine culture: The doctor places a thin plastic tube (catheter) into the child’s bladder.
• Subrapubic urine collection: The doctor inserts a thin needle through the child’s lower stomach into their bladder. This is usually a last resort when other methods have failed.
• Urine collection bag: The doctor places a plastic bag beneath the child’s vagina or penis to collect urine. This method is the least reliable.

Based on the test result, the doctor may perform other tests to rule out conditions similar to UTIs or determine the cause.

If your child has frequent infections, your family doctor may order an ultrasound or voiding cysto-urethrogram (VCUG) before referring you to a specialist. A VCUG allows your doctor to evaluate your child’s bladder and urethra using contrast and X-rays.

Treatment for a UTI depends on the cause and your child’s age. Infants often require treatment in the hospital. This is because they need antibiotics through an IV (intravenous) or catheter. Older children can take medicine at home.

Things to consider

There are several things you can do to help prevent UTIs in children.

• Keep your child’s genital area clean. This helps prevent bacteria from forming or spreading.
• Have your child drink plenty of non-sugar-sweetened fluids, especially water.
• Teach your child not to hold it too long when they need to go to the bathroom. A backup of urine in the bladder can lead to bacteria growth.
• Teach your child to wipe from front to back when they go to the bathroom. This is especially important for girls.
• Do not dress your child in clothes that are too tight.
• Always bathe your child after swimming or being active.

When to see a doctor

Call the doctor if your child’s symptoms don’t improve or get worse with medicine. If your child gets a UTI more than once in 6 months, the doctor may want to switch treatments.

Questions to ask your doctor

• How did my child get a UTI?
• How long will my child need to take antibiotics?
• What is the risk of my child getting more UTIs in the future?
• Does treatment vary if my child gets UTIs often?
• What conditions are related to UTIs?

Resources

Urology Care Foundation: Urinary Tract Infections in Children

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