What Does Burning or Painful Urination (Dysuria) Mean?

A painful or burning sensation while urinating can be caused by a number of medical conditions, ranging from mild to serious. Painful urination is known as dysuria.

Pain while urinating is typically felt in the urethra, the tube that carries urine out of the bladder, or in the area around the genitals. (1)

The most common cause of dysuria is a urinary tract infection. (2)

Painful urination may feel like burning, stinging, or itching, and it can occur at the start of urination, during urination, or after urination. (3)

People who feel pain at the beginning of urination often have a urinary tract infection. Discomfort after urination can often indicate bladder or prostate issues. (2)

You should seek medical attention if you experience symptoms in addition to painful urination, such as: (1)

• Discharge from the penis or vagina
• Smelly or cloudy urine
• Frequent urge to urinate
• Passing kidney or bladder stones
• Blood in urine
• Nausea or vomiting
• Itching in the genital area
• Fever
• Back or side pain
• Wetting accidents in children

It’s also important to contact your doctor if you experience any burning during urination while pregnant, or if the painful urination lasts longer than 24 hours. (4)

A common cause of painful urination is a lower urinary tract infection or inflammation in the urinary tract. Infection occurs when bacteria enter the urethra and travel to the bladder.

Women ages 20 to 50 are more likely to experience bladder infections (cystitis) and therefore painful urination. (5) Pregnant women, people with diabetes, postmenopausal women, and people with bladder diseases are also at higher risk of bladder infections and dysuria. (2)

Upper urinary tract infections, or kidney infections, can also cause dysuria. Kidneys become infected when bacteria travel to the kidney from the bladder. Pregnant women, people with diabetes, people with a history of kidney stones, and men with an enlarged prostate are more likely to experience upper urinary tract infections. (5)

Vaginitis, or inflammation of the vagina, can also cause painful urination. Vaginitis can be caused by an allergic reaction to chemicals (such as spermicides, soap, or bubble bath), low levels of estrogen, yeast infections, bacterial vaginosis, or the sexually transmitted infection trichomoniasis. (5)

Urethritis, or inflammation of the urethra, can also cause painful urination. Causes typically include sexually transmitted infections like gonorrhea and chlamydia, a reaction to irritating chemicals, or irritation from the insertion of a catheter. (5)

Causes of dysuria can also vary by gender. Women often experience dysuria with: (4)

• Irritation of vaginal tissue
• Atrophic vaginitis during menopause
• Herpes infection in genitals
• Dietary factors
• Sexual intercourse

Men may experience burning with urination if they have prostate disease (an inflamed or infected prostate) or cancer. (3) Men over age 50 are more likely to experience bladder infections due to prostate issues. (5)

Additional causes of painful urination for both men and women can include: (4)

• Interstitial cystitis
• Damage to bladder due to radiation therapy
• Bladder spasms
• Prostate infection
• Sexually transmitted infections
• Psoriasis
• Stevens-Johnson syndrome
• Behçet’s disease

Irritation of the urethra from chemicals is the most common cause of painful urination in children. These chemicals often include skin lotions, bubble bath chemicals, or soaps.

Other causes of painful urination in children can include: (6)

• Bacterial bladder infection
• Viral bladder infection
• Labial adhesions
• Minor trauma from activities

Contact your child’s doctor if you notice any of these symptoms: (6)

• Painful urination lasts for more than three days
• Fever
• Inability to urinate
• Redness or rash in genital area
• Discharge from penis or vagina
• Bloody, cloudy, or smelly urine

Localized trauma from sexual abuse can also cause painful urination. If you have concerns about child abuse, talk to your child’s doctor. You can also report the abuse to the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (800-422-4453).

To determine the cause of painful urination, your doctor may perform a urinalysis to analyze the number of white blood cells, red blood cells, protein, glucose, and foreign chemicals in your urine. The presence of white blood cells in urine can indicate a urinary tract infection. (3)

Your doctor may also perform a urine culture to determine what kind of bacteria might be causing a urinary tract infection and what antibiotics will best treat the infection. (3)

Anne Schuckman, MD, an associate professor of urology at the University of Southern California in Los Angeles, warns that a urine dipstick test alone may not be enough to properly diagnose and treat a urinary tract infection. “In order to truly know if you have an infection, and what the appropriate antibiotic is, a patient needs a formal urinalysis and a urine culture,” she says.

Additional tests can include: (4)

• Pelvic exam
• Vaginal fluids exam
• Urethral swab
• Kidney or bladder ultrasound
• Cystoscopy
• MRI (magnetic resonance imaging)
• CT (computerized tomography) scan
• Sexually transmitted infection screening

Treatment for painful urination will differ depending on the cause of the discomfort. Urinary tract infections are treated with antibiotics, and dysuria usually dissipates within a few days. If there is skin irritation that has caused inflammation, your doctor may advise you to avoid whatever is irritating the skin. (3)

Vaginitis is typically treated with antibiotics, and yeast infections are often treated with antifungal medication. (5)

If you have a severe kidney infection (pyelonephritis), your doctor may administer antibiotics intravenously before eventually treating you with antibiotic pills or capsules. (5)

Your doctor may also give you recommendations to help reduce the level of pain, which can include drinking more fluids, taking over-the-counter medication, such as acetaminophen (Tyenol) or ibuprofen (Advil), or changing dietary habits. (7)

If your child is experiencing irritation due to chemicals like bubble bath, your doctor may recommend an over-the-counter diaper cream. (6)

There are several changes in daily habits that can prevent painful urination. Drinking several glasses of water per day can reduce the risk of dysuria. Safe sex practices, such as using a condom, can also prevent sexually transmitted diseases that can cause painful urination. (5)

Parents of young girls should make sure they do not play in wet swimsuits for too long, as this can cause irritation. They should also not take frequent bubble baths. (5)

Women are advised to urinate after sexual intercourse to prevent bacteria from traveling to the bladder. And they should be sure to wipe with toilet paper from front to back after a bowel movement.

Women should also switch tampons and sanitary napkins frequently when menstruating, and avoid douches and vaginal sprays. (5)