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7 Causes of Painful Urination

Painful urination is usually caused by infections like a urinary tract infection (UTI), cystitis, or prostatitis, but may be caused by kidney stones. Infections can be treated with antibiotics, and there are treatments to ease the pain until the underlying cause is treated.
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Written by
Jason Chandrapal, MD.
Interprofessional Advanced Clinical Simulation Fellow. Durham, NC
Last updated June 19, 2022

Painful urination quiz

Take a quiz to find out what's causing your pain.

Painful urination quiz

Take a quiz to find out what's causing your pain.

Take painful urination quiz

Painful urination (dysuria) is pain and burning that occurs when you urinate. It affects both men and women and can develop at any age. It’s often caused by an infection, such as a urinary tract infection (UTI), cystitis, or prostatitis. But it can also be caused by kidney stones, an injury, or exposure to chemical irritants, such as soaps or spermicides.

What painful urination feels like

Pain can start at any point while urinating (beginning, middle, or end). You may feel dull and achy pain or sharp, stabbing, or burning pain.

Other symptoms you may have are increased urinary frequency and urgency, blood in your urine, cloudy urine, foul-smelling urine, and abdominal pain located just above the genitals.

Should I go to the doctor if it hurts to urinate?

“It’s important to seek medical attention early for painful urination as it can progress to make you feel worse or even require hospitalization. Painful urination is very common and easily treatable, but usually, it won’t go away on its own.”—Dr. Jason Chandrapal

Common causes

1. Urinary tract infection (UTI)

Found in both men and women, but more common in women

Urinary tract infections, or UTIs, are infections of the bladder or urethra (the tube that shuttles urine out of the body). The bacteria invade your urinary tract and can multiply, causing inflammation. In some cases, the bacteria can come from an outside source, such as sexually transmitted infections during intercourse.

Other symptoms include frequent urination; urgency; red, pink, or cola-colored urine; foul-smelling urine; cloudy urine, and lower abdominal pain just above the genitals.

UTIs are treated with prescription antibiotics.

2. Cystitis

Found in both men and women

Cystitis is a bladder infection. While cystitis can occur in men, women are more likely to get it because they have a shorter urethra than men. This means bacteria have to travel a shorter distance to enter and infect the bladder.

Other symptoms are similar to those of a UTI. Cystitis is treated with prescription antibiotics.

Painful urination quiz

Take a quiz to find out what's causing your pain.

Take painful urination quiz

3. Sexually transmitted infections

Sexually transmitted infections (STIs) such as gonorrhea and chlamydia can cause pain when urinating. Symptoms normally appear a few days after having sexual intercourse with a new partner. They include burning with urination, urinary urgency or frequency, or pus-like fluid coming from the urethra.

STIs are treated with antibiotics.

What STDs cause painful urination?

“Gonorrhea and chlamydia in particular are known for causing pain with urination. If you suspect you have an STD, see your doctor or go to a health center.”—Dr. Chandrapal

4. Kidney stones

Found in both men and women, but more common in men

Kidney stones are hard deposits of salt and minerals that form in your kidneys. They affect 1 in 11 people in the U.S., according to a review article in European Urology.

Kidney stones may be caused by dehydration, eating habits (such as eating too much animal protein), or having certain medical conditions, including gout, inflammatory bowel disease, hyperparathyroidism, and some kidney diseases.

As a kidney stone passes through the urethra, it can get stuck and block the urethra or damage the tissues. This causes intense flank pain, and sometimes nausea and vomiting.

Other symptoms are similar to those of a UTI.

You may be able to treat small stones by drinking water and taking pain relievers. Your doctor may also prescribe an alpha-blocker, which relaxes the muscles in your ureter to help you pass the stone faster and with less pain. Symptoms go away as soon as you pass the stone.

Large stones that are unable to pass or are too painful to pass may have to be broken up with surgery that uses sound waves or a scope inserted in your ureter or kidney.

5. Prostatitis

Found in men

Prostatitis is an infection of the prostate gland. It can be caused by bacteria in the urine that enters your prostate. In many cases, the cause is unknown. Because the urethra travels through the prostate, infection of the prostate can cause painful urination.

Symptoms are similar to those of a UTI, and you can also have dull, achy pain in the genital region. Prostatitis is treated with antibiotics.

6. Epididymitis

Found in men

Epididymitis is a bacterial infection of the epididymis, the tube that connects the testicles and urethra. It stores and transports sperm into the ejaculate. Epididymitis is usually caused by E. Coli and bacteria that cause sexually transmitted infections.

Other symptoms include scrotal or testicular pain that feels dull and achy. There may also be scrotal or testicular swelling, blood in your semen, and fever and chills. The condition is treated with antibiotics.

7. Chemical irritants

Found in both men and women

Ingredients in personal care products can irritate the urethra and cause pain when urinating. These include soaps, bubble baths, lubricants, or spermicides. It’s more like an allergic response. The pain generally goes away on its own once you stop using the product that’s causing the irritation and inflammation.

Should I be concerned about frequent and painful urination?

“An important question to ask your doctor is: If the pain still occurs after treatment, when should I be concerned and come back? Also, always tell your doctor about any fever as it can be a sign of more systemic infection.”—Dr. Chandrapal

Medicine for painful urination

Since most of the time, pain when urinating is caused by infections, the usual treatment is antibiotics. Your provider may start you on a broad-spectrum antibiotic after doing a urine culture and then, depending on the lab results, prescribe a more specific antibiotic.

You may take over-the-counter pain medication such as ibuprofen to help with the pain until the antibiotics start working. If you are diagnosed with a kidney stone, you may be prescribed narcotic pain medication to relieve pain as the stone passes.

Painful urination quiz

Take a quiz to find out what's causing your pain.

Take painful urination quiz

Prevention

Ways to prevent pain when urinating include:

  1. Drink plenty of fluids. This flushes bacteria out of the body and can prevent infection.
  2. Take cranberry extract tablets. This OTC therapy can prevent bacteria from attaching to the lining of your urinary tract.
  3. Try probiotics. Taking probiotics helps the “good” bacteria multiply in the lower urinary tract and vagina, which prevent infection from more aggressive bacteria.
  4. Practice proper genital hygiene. Routinely cleaning the genital area with mild, fragrance-free soap can improve hygiene and prevent infections and skin irritation from stool or urine.
  5. Avoid genital skin irritants such as spermicides.

FAQs about painful urination

Why does it sting when I urinate?

Stinging or burning after urinating may be caused by infections of the bladder and urethra like gonorrhea, chlamydia, or herpes. Other causes include chemicals entering the urethra like detergents from clothes, fabric softeners, perfumed soaps, and bubble baths. Notably, those causes do not cause a discharge.

Can pain when urinating be a sign of pregnancy?

No, painful urination is not considered a sign of pregnancy. Pregnant women do have a higher rate of bacterial infections in their urine. This is because of the effects of the pregnant uterus on the bladder and its ability to fully empty. Though it’s a risk of pregnancy, it is not common enough to be considered a sign of pregnancy.

Can a UTI go away on its own?

There is little evidence that a UTI routinely can go away on its own. Once in a while, the UTI may disappear as the body fights the infection. More often, the UTI gets worse by moving up into the urinary tract, causing bladder and kidney infections. Generally, UTIs should be treated immediately.

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Interprofessional Advanced Clinical Simulation Fellow. Durham, NC
Dr. Chandrapal is the current Interprofessional Advanced Clinical Simulation Fellow at the VA medical center in Durham, NC. Prior to his current position he was a urology resident at Duke University. Originally from Houston, TX he went to undergrad at the University of Texas in Austin, followed by a masters degree from the University of Texas Health Science Center in San Antonio, and medical schoo...
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