Dysuria refers to painful or uncomfortable urination. It is one of a constellation of ''irritative'' bladder symptoms (also sometimes referred to as lower urinary tract symptoms), which includes nocturia and urinary frequency.

Diagnosis

The clinician should also look for physical findings of fever, rash, direct tenderness over the bladder area, and joint pain. Physical findings of increased temperature, increased pulse, low blood pressure in the presence of dysuria can indicate systemic infection. Urological obstruction due to stone or tumor can result in findings of hematuria, decreased urination, and bladder spasms. All these physical findings should be looked for carefully while obtaining history. History regarding recent sexual activity is crucial. Urinalysis is the most useful test to start the work up in a patient of dysuria. Urinalysis positive for nitrite carries a high predictive value of a positive urine culture. Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher. If the patient only has leukocyte esterase or bacteria in the urine, then dysuria may suggest that the patient probably has urethritis.

Differential diagnosis

This is typically described to be a burning or stinging sensation. It is most often a result of a urinary tract infection. It may also be due to an

STD Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral sex ...

bladder stones A bladder stone is a stone found in the urinary bladder. Signs and symptoms Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is d ...

bladder tumors Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. Symptoms include blood in the urine, pain with urination, and low back pain. It is caused when epithelial cells that line the bladder become mali ...

, and virtually any condition of the prostate. It can also occur as a side effect of anticholinergic medication used for Parkinson's disease.

Drugs and irritants

* Chemical irritants, e.g., soaps, tampons, toilet papers * Drugs, e.g.,

Cyclophosphamide Cyclophosphamide (CP), also known as cytophosphane among other names, is a medication used as chemotherapy and to suppress the immune system. As chemotherapy it is used to treat lymphoma, multiple myeloma, leukemia, ovarian cancer, breast cancer ...

, Ketamine * Capsaicin consumption, e.g.,

habanero The habanero (; ) is a hot variety of chili. Unripe habaneros are green, and they color as they mature. The most common color variants are orange and red, but the fruit may also be white, brown, yellow, green, or purple. Typically, a ripe haba ...

peppers

Genital

* Benign prostatic hyperplasia (male) *

Endometriosis Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, f ...

(female) * Prostatic cancer (male) * Prostatitis (male) * Vaginitis (female)

Urinary tract

One of the most common causes of dysuria is urinary tract infection. Urinary tract infections are more common in females than males due to female anatomy, having a shorter and straight urethra compared to males who have a longer and curved urethra due to male anatomy. In females, bacteria can reach the bladder more easily due to shorter and straight urethra as they have less distance to travel. Because of these reasons, females tend to experience dysuria more frequently compared to males. Also, most urinary tract infections are uncomplicated. CC-BY icon

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* Chlamydia * Cystitis * Hemorrhagic cystitis * Kidney stones * Malignancy, i.e., bladder cancer, prostatic cancer, or urethral cancer * Prostatic enlargement, i.e., benign prostatic hyperplasia (male), prostatic cancer * Prostatitis (male) * Pyelonephritis * Sexually transmitted disease * Trichomoniasis * Urethral stricture * Urethritis * Urinary

schistosomiasis Schistosomiasis, also known as snail fever, bilharzia, and Katayama fever, is a disease caused by parasitic flatworms called schistosomes. The urinary tract or the intestines may be infected. Symptoms include abdominal pain, diarrhea, bloody s ...

* Urinary tract infection (UTI) caused by bacterial infection

Other

Diverticulitis Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine. Symptoms typically include lower abdominal ...

* Hypotension * Mass in the abdomen * Reactive arthritis * Acute intermittent porphyria *

Hereditary coproporphyria Hereditary coproporphyria (HCP) is a disorder of heme biosynthesis, classified as an acute hepatic porphyria. HCP is caused by a deficiency of the enzyme coproporphyrinogen oxidase, coded for by the ''CPOX'' gene, and is inherited in an autosom ...

Variegate porphyria Variegate porphyria, also known by several other names, is an autosomal dominant porphyria that can have acute (severe but usually not long-lasting) symptoms along with symptoms that affect the skin. The disorder results from low levels of the en ...

References

External links

{{Authority control Symptoms and signs: Urinary system