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Painful urination

SYMPTOMS

What is painful urination?

Painful urination refers to a burning or stabbing pain in the lower abdomen (commonly known as the "lower belly") or urethra during or after urination[1,2]. It is often caused by urinary tract inflammation or stones, but in children and young adults, painful urination may also result from traumatic factors (such as masturbation, sexual activity, etc.)[1,3].

TREATMENT

How to effectively relieve painful urination?

Before seeking medical treatment, patients can temporarily alleviate symptoms through the following measures:

  1. Sit or lie down to keep the body in a relatively quiet and relaxed state, diverting attention from urination, which may partially relieve pain in some cases;
  2. Ensure adequate hydration by drinking at least 1500 mL of water daily (equivalent to three standard bottles of mineral water) to help flush out harmful substances like bacteria from the body[4];
  3. If the pain is unbearable, apply a warm towel to the painful area or take oral pain relievers (such as ibuprofen, flavoxate, morphine, or pethidine) to alleviate discomfort[5];
  4. Painful urination is often caused by lower urinary tract infections. Under a doctor's guidance, oral antibiotics (such as penicillin or ceftriaxone) may be prescribed.

Note that these methods only provide temporary relief and do not cure painful urination completely. Therefore, if experiencing painful urination, seek medical attention promptly to identify the underlying cause and receive targeted treatment.

DIAGNOSIS

When should you seek medical attention for painful urination?

Patients with painful urination should actively seek medical care if any of the following conditions occur[6,7]:

  1. Painful urination accompanied by urgency, frequent urination, hematuria, fever, etc.;

  2. Painful urination with back pain or flank pain;

  3. Severe, unbearable pain that significantly affects daily life;

  4. Pregnant women experiencing painful urination should seek medical attention promptly;

  5. Patients with immune system disorders (e.g., immunodeficiency diseases);

  6. Recurrent painful urination or symptoms lasting more than two weeks;

  7. Patients with a clear history of trauma should seek medical care.

Which department should you visit for painful urination?

Priority should be given to the urology department. If back pain accompanies painful urination, a nephrology consultation may also be appropriate.

What tests are needed for painful urination?

After consultation, in addition to medical history inquiries (e.g., past illnesses) and basic physical examinations (such as visual inspection of the perineum or abdominal palpation), doctors may recommend urinalysis, urinary tract ultrasound, urine culture with sensitivity testing, and cystoscopy.

  1. Urinalysis: Determines whether the patient has a urinary tract infection;

  2. Urinary tract ultrasound: Assesses the presence of urinary stones;

  3. Urine culture and sensitivity testing: Often performed alongside urinalysis, typically using midstream urine to identify pathogens and guide treatment;

  4. Cystoscopy: Evaluates potential urinary tract stones or tumors[2,3].

POTENTIAL DISEASES

What are the common causes of painful urination?

  1. Lower urinary tract infections: Including urinary tract infections and infections of adjacent organs, such as cystitis, urethritis, prostatitis, endometritis, salpingitis, vaginitis, etc., which may be accompanied by symptoms like fever and lower back pain[1,2,6].
  2. Tumors: Including tumors of the urinary system and adjacent organs, such as bladder cancer, urethral cancer, prostate cancer, endometrial cancer, rectal cancer, etc., often accompanied by symptoms like hematuria and dysuria[2].
  3. Stones or foreign bodies: Such as bladder stones or urethral stones[1].
  4. Local trauma: Minor trauma is another relatively common cause of urethral irritation. In older children and adolescents, normal exploratory play, masturbation, sexual activity, or sexual abuse may be causes of trauma[1]; in adults, urinary tract surgeries (including diagnostic or therapeutic procedures involving urological instruments, such as urethral dilation) may also cause trauma[7].
  5. Chemical or physical factors: Such as soap, perfume, or other personal care products entering the urethra, or medications like cyclophosphamide used in cancer treatment, which can cause painful urination[7]. Additionally, radiation therapy for cervical or bladder cancer may lead to radiation cystitis, resulting in painful urination[8].
  6. Other factors: Such as secondary infections due to urethral caruncle, bladder diverticulum, or neurogenic bladder.