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What is Dysuria? Causes, Symptoms, Differential Diagnosis & Treatment

What causes dysuria? What are the symptoms of dysuria in men and women? How is dysuria diagnosed? How is dysuria treated? All these questions have been answered in this article. Read to understand the different aspect of this disease that affects the urinary tract in both men and women

What is Dysuria?

Dysuria is a painful sensation during urination or difficulty in urinating. It is a very common presentation in primary care. Treatment depends on identifying the underlying causes. It does not refer to urinary frequency through disorders of frequency can often be accompanied by dysuria.  It is most common in women than in men and more common in older men than younger men.

This condition is very common among people all over the world, and approximately 5 to 15% of all doctor consultations are about similar problems. Young and sexually active women are more likely to have these symptoms. Diseases of the urinary tract (UTI) mostly relate to dysuria. Any infection of the bladder, urethra or kidney may also result to this ailment.

What are the causes of Dysuria?

Have you ever thought of what causes dysuria?  There are several causes of this condition, which include:

  1. Lower urinary tract infection (cystitis or bladder infection): this is a bladder infection and is most common in women aged 20 to 50 years. It often starts when bacteria enter the urethra. The bacteria can also enter the urethra in women and girls who wipes themselves with toilet tissue from back to front. Once the bacterium enters a female system, it only travels a short distance to the bladder. In men over 50 years, a bladder infection is usually associated with enlarged prostate.
  2. Upper urinary tract infection (pyelonephritis or kidney infection): A kidney usually becomes infected as a result of bacteria traveling to the kidney from a bladder infection. It is common during pregnancy in women, men with enlarged prostate, people with persistent kidney stones and abnormal bladder function.
  3. Urethritis; this is an inflammation of the urethra. Usually caused by the sexually transmitted disease. It can also result from contact with urinating chemicals such as antiseptics, bubble bath or some spermicidal or irritation from an object such as tube inserted to drain urine.
  4. Vaginitis: Many people do not understand the definition of vaginitis. Vaginitis is simply inflammation of the vagina. It results from an allergic reaction to irritating chemicals such as spermicide or bath soap. It results from infections such as bacterial vaginosis, candidiasis, and trichomoniasis.
  5. Physical activities such as horse or cycle riding can trigger symptoms of dysuria.

Symptoms of dysuria

Depending on the various causes of dysuria there are many other symptoms in addition to pain while urinating. We will categorize the different objects with their various symptoms

  1. Lower urinary tract infection (cystitis): associated with this disease include frequent urination, an intense urge to urinate, loss of bladder control, pain in the lower front portion of the abdomen usually near the bladder, cloudy and bloody urine that usually has an odor.
  2. Urethritis: redness around the opening of the urethra, frequent urination, and vaginal discharge.
  3. Upper urinary tract infection: pain in the upper back, high fever with shaking chills, nausea and vomiting, cloudy urine, frequent urination and intense urge to urinate.
  4. Vaginitis: Pain, soreness or itching in the vagina or foul-smelling vaginal discharge or odor, discomfort or pain during intercourse.
  5. Burning sensation or slowness during urination.
  6. Blood in urine or itchy vaginal discharge and upper back pains.

Dysuria differential diagnosis

Dysuria defined as pain, burning or discomfort on urination is more prevalent in women than in men. Urinary tract infection is the most frequent cause of dysuria, treatment by antibiotics is not always appropriate. Have you ever thought why dysuria is most common in younger women? Reason being their frequency in indulging in sexual activities. However, older men are more likely to have dysuria because of an increased incidence of prostatic hyperplasia.

A comprehensive history and physical examination can often reveal the cause of dysuria.  In healthier patients who have uncomplicated medical histories and symptoms urinalysis is not done. However in other patients urine helps in determining the presence of infection and confirms a suspected diagnosis.

Urine cultures and both urethral and vaginal smears and cultures can assist in determining sites of infection and causative agents. Radiography and other forms of imaging may also identify abnormalities in the upper urinary tract when symptoms are more complex.

If you experience pain during urination, it is advisable to visit a doctor. The doctor will ask about your symptoms, personal and sexual habits. During a physical examination, your doctor will check for tenderness over the kidney and examine your genitals. For women, a pelvic examination may be conducted, and digital rectum examination carried out in men with suspected prostate.

A swab of infected area may need to be taken and tested in case of vaginitis and urethritis. In the event of a kidney infection, a urine sample undergoes a test to identify the bacteria species. If you have a fever or appear ill, a blood sample is tested to determine the type of bacteria in the blood.

If you have dysuria and have had unprotected sex with multiple partners, your doctor may order a test to look for the various types of sexually transmitted diseases.

Dysuria Treatment Drugs

It is worth noting that dysuria treatment depends on its cause. Most people with an infection of the urinary tract respond well to treatment within a few days. When the reason is harder to determine, symptoms may last longer.

  1. Treatment of Cystitis and pyelonephritis related infection is by use of antibiotics taken orally (by mouth): Antibiotics may be given into a vein for severe pyelonephritis with high fever, shaking chills and vomiting. Many patients obtain excellent relief from symptoms of cystitis with over the counter medicine. Urinary alkalizing agent in some renal disorders uses sodium bicarbonate.
  2. For Urethritis related causes the treatment requires antibiotics: The antibiotic depends on the infection that caused urethritis. You will be administered with an antibiotic if found with positive gram stain or culture results and to all sexual partners you have regardless of the symptoms. Patients with negative Gram stain results and a history consistent with urethritis will also get treatment. Some of the drugs recommended include oral ofloxacin, oral ciprofloxacin, oral cefixime and parenteral ceftriaxone.
  3. Vaginitis related dysuria involves the treatment of trichomoniasis and bacterial vaginosis using antibiotics. Antifungal drugs treat yeast infection either as a mouth pill or as a suppository or cream inserted into the vagina.

It’s worth noting that a single episode of infection in the bladder, kidney, urethra and vagina is usually treated entirely after administration of antibiotics if treated.

In most cases there is a slight risk of long-term damage. However, women with certain sexually transmitted diseases can lead to scarring of the reproductive tract and fertility problems if not diagnosed and treated. Dysuria should be evaluated by your physician to expedite treatment if it’s found necessary. Pain in the upper back accompanied by fever are signs of kidney infections and must be treated immediately to avoid severe illness.

Dysuria Prevention

It is advisable for women to keep their genitals clean and dry to prevent dysuria caused by irritation. Change sanitary towels frequently and avoid using irritating soaps, vaginal sprays and douches. Washing girls thoroughly but gently after playing in the sand, being wary of extended play in swimsuits helps reduce irritation and redness of the vulva in girls. Limiting bubble baths is also recommended in girls.

To help prevent dysuria caused by sexually transmitted diseases, one should practice safe sex always that is; using a condom each time one wants to get intimate unless you have one faithful, steady sexual partner.

Drinking several glasses of water each day to flush out your urinary tract prevents dysuria caused by cystitis or pyelonephritis. Women should wipe themselves from front to back after having a bowel movement. They should also urinate frequently after sexual intercourse to flush bacteria away from the urethra. As a result prevents bacteria from moving to the bladder.

Protecting the urinary tract from trauma and seeking early care for possible infection may decrease the risk of pain. Avoiding tight-fitting clothes may reduce the pain that goes along with allergic reactions and genital irritation. Limiting caffeine intake may also reduce the person’s risk of having dysuria.

Painful urination is not necessarily contagious and poses no risk to others. However, if the cause is an infection, for example, a sexually transmitted disease, the infection may be contagious. Finally, maintaining a good personal hygiene reduces the chances of acquiring dysuria.

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