Overview

Both men and women, regardless of age, can experience painful urination. This condition though is more commonly experienced by women and is usually related to having urinary tract infection or UTI.  

Painful urination most often is a symptom of urinary tract infection. It may also be due to having inflammation in the urinary tract, which is composed of the urethra, bladder, kidneys, and ureters. 

The pain may come from either the perineum, bladder, or the urethra. In men, the location of the perineum is between the anus and the scrotum. In women, it lies between the anus and the opening of the vagina. The urethra, on the other hand, is the tube responsible for transporting the urine outside the body.  

Many of us may have experienced painful urination one way or another because it is a common condition, but what makes it unusual is when it is accompanied by burning, feel itching, or pain that does not go away quickly. 

When symptoms such as these become present, it is advised to see a doctor as it can be an indication of some underlying medical conditions. Most conditions that are related to painful urination are treatable. At the onset of irregular signs, do consult your healthcare provider right away so you can be diagnosed and appropriately treated. At the same time, this prevents the situation from getting worse.

Although painful urination is frequent in both men and women, there are some groups of individuals who are at a higher risk than the rest. These are pregnant women, men, and women who have diabetes, women in their menopausal stage, and any person that has any type of bladder disease.

Being aware of how often you pee is also somewhat substantial as it can indicate your general well- being.  

Causes of Painful Urination

This condition is a common sign of several different reasons, and most of which are associated with bacterial infection or inflammation in the bladder or urinary tract area. Some of the reasons are:

• Urinary tract infection or UTI, which can be an inflammation of the urinary tract or a result of an excess of bacteria build-up anywhere in the urinary tract. Some signs of UTI are cloudy urine, cause frequent urination, foul-smelling urine, pain in the side and back, fever, or blood-tinged urine.

Women are more prone to experiencing this type of condition because their urethra is shorter than men, so the bacteria then can travel faster in the bladder.

• Prostatitis is an inflammation of the prostate gland and has the following symptoms: discomfort, stinging, and feels burning during urination.
• Sexually transmitted diseases or STIs such as chlamydia, gonorrhea, genital herpes, and trichomoniasis. The latter cause vaginal infection. For STI, it is best to be screened for these infections as they do not usually have visible signs. 
• Cystitis, an inflammation of the bladder’s lining
• Interstitial Cystitis (IC), the most common type of cystitis, which also results in having a painful bladder.
• Vaginal infection in the form of either vaginitis or vaginosis is a type of virus that happens because of too much growth of yeast or bacteria.
• Inflammation of the urethra
• Inflammation of the vagina which may be due to different causes like dietary reasons, sexual intercourse, contraceptive sponges, and others as such.
• Other prostate diseases
• Types of cancer such as bladder cancer
• The ovarian cyst can grow on one or both of the ovaries that are located on either side of the bladder. This condition is similar to that of the kidney stones wherein an element outside the bladder presses against it, thereby causing pain during urination.

Apart from an inflammation in the area or bacterial infection, other factors that may cause pain during urination could also be:

• Radiation therapy
• Kidney stones 
• The chemical reaction is associated with the products that you use in the genital area, such as toiletry products, soaps, lotions, bubble baths, or even laundry detergents.
• Side effects of treatment like chemotherapy or radiation, or a result of medication.

Though painful urination affects both men and women of any age, their signs, as well as underlying conditions, vary. For the male, pain can be felt in the penis before and after urination; as for the female, the pain can be experienced internally and externally. If it is external, it can mean an irritation of sensitive skin.

If the pain is experienced at the start of urination, it can be a sign of urinary tract infection. And if the pain occurs after urination, it can be an issue on the prostate or bladder.

Diagnosis and Treatment

Any person experiencing pain or discomfort during urination should not take it lightly, most especially if the symptoms are persistent. See a doctor know the reason for having painful urination, and also to find out what proper treatment or medication to use to resolve the condition. It may also be due to a more serious medical concern, and you might need a specialist.

The treatment will all depend on the result of your physician’s diagnosis. That is why the 1st step is to determine what is causing the pain during urination. Is it an infection, inflammation, dietary factors, or an issue in the bladder or prostate?

For the doctor to be able to give the right diagnosis properly, a description of the symptoms may be asked, and some laboratory work will be required.

Some laboratory tests that may be needed are:

• Urine analysis to check for the presence of white blood cells, red blood cells, or other foreign chemicals. If there are white blood cells in the urine, it could mean inflammation in the urinary tract.
• A urine culture will let the doctor know if there is bacteria or infection that is causing the UTI. Through this, the right type of antibiotic can be determined. This type of lab work usually takes two days before the result comes out.

If the cause of painful urination is not an infection, other tests related to the bladder or prostate may be required. For women, a swab sample of the vaginal lining or urethra may be done to check for signs of infection.

On the trip to the doctor, expect to be asked about your medical history medical conditions, and your sexual activities. These questions will help find out if you may have an STI.

For the STI, some lab tests may be required.

The use of antibiotics can resolve most issues about painful urination, but depending on the cause:

• UTI can be treated with antibiotics, but if severe, an intravenous antibiotic may be given.
• Prostatitis is also treated with antibiotics, but treatment may take up to 12 weeks.
• For chronic bacterial prostatitis, some over-the-counter anti-inflammatory medications may be prescribed, or prostatic massage or hot baths to relax the muscles around the prostate may be required.
• For Interstitial Cystitis (IC), certain medications may be prescribed, such as tricyclic antidepressants, Elmiron or pentosane polysulfate sodium, and Tylenol or acetaminophen with codeine.

Once the patient starts taking the prescribed medications for bacterial infection, their condition usually improves quickly except for the case of the IC, which takes a longer time, like up to 4 months before starting to feel the effect of the drug.

If an infection is not the case, these treatments may be directed to the patients:

• Have more fluid intake to dilute the urine making excretion less painful.
• Avoid using products near the genital region with harsh chemicals.
• Have plenty of rest
• Over-the-counter medications to reduce irritation or discomfort
• Change your diet and avoid food and drinks that may irritate the bladder like alcohol, caffeine, citrus juices and fruits, tomato products, spicy foods, and artificial sweeteners.
• For sexual activity, use condoms for protection against STI.

Normal Conditions

Although there is an average estimate on the regular frequency of urination, there are some factors that affect how we pee, which then makes the normal conditions also vary. Some of these are:

• Age
• Medical condition like UTI or diabetes
• How much you drink 
• Bladder size
• Use of medication

For some exceptional cases as during pregnancy and weeks after giving birth, the frequency of urination is increased.  

The standard urinary frequency is said to be:

• 6 to 7 times for 24 hours
• 4 to 10 times throughout the day can also be reasonable if the person is healthy

The average urine output is around 0.5 to 1.5 cc/kg/hour. The urinary bladder is capable of holding a maximum of 600 ml of urine per day, but at about 150 ml, we would start to have the urge to urinate.

Risks of Having Painful Urination

Having painful urination should not be thought to be dismissed because if left untreated, more severe and severe medical conditions may arise.  

The growth and excess of bacteria in the urinary tract may result in an infection. If the urinary tract infection is not treated at the soonest time, the condition could lead to kidney damage.  

If there is avoiding dysfunction, which makes the emptying of the bladder difficult, the condition may affect the nerve function.

When to Seek Medical Attention

Before you even start to see or feel these symptoms, it is recommended that you see your doctor:

• Discharge from the penis or vagina
• Foul-smelling urine
• Cloudy or blood-tinged urine
• Pain in the side or back
• Fever
• Persistent pain

Table of Medications

• ciprofloxacin
• nitrofurantoin
• Cipro
• Macrobid
• Bactrim
• sulfamethoxazole / trimethoprim
• Amoxil
• amoxicillin
• Bactrim DS
• Augmentin