Why does it hurt when I pee? Common conditions that cause dysuria

Urination should not be painful. If it hurts when you pee, this could be a sign of an underlying medical condition. Painful urination is medically referred to as dysuria. While it can happen to men and women of any age, it is more common in women, people with diabetes or those with bladder disease. 

What causes pain when urinating? While most people associate painful urination with bladder infections, there are other conditions that can be causes of painful urination. If you’re experiencing dysuria, here are some reasons why it hurts to pee. 

UTIs

Urinary tract infections (UTIs) are the most common cause of painful urination. UTIs are common bacterial infections that can affect the bladder, kidneys and urethra. 

Other symptoms of UTIs may include abdominal pain, frequent urination or urgency and blood in the urine. If you think you have a UTI, it is important to see a healthcare provider to get the proper treatment. 

Mycoplasma

Mycoplasma genitalium are tiny bacteria that can infect the genital tract and be transmitted from one partner to another during sexual activity. Symptoms of mycoplasma in females include: 

  • Abnormal vaginal bleeding
  • Dysuria
  • Pain with sex
  • Vaginal discharge

Symptoms of mycoplasma in males include: 

  • Dysuria
  • Penile discharge 
  • Urethral swelling

A urine test is commonly used to diagnose mycoplasma infections. The infection can be cured with a course of oral antibiotics. Typically, both partners will be treated at the same time to prevent passing the infection back and forth. 

Interstitial cystitis

Interstitial cystitis (IC) is a condition that causes chronic inflammation in the bladder. IC can cause:

  •  Dysuria 
  • Frequent urination
  • Pain with sex
  • Pelvic pain
  • Persistent urge to urinate 

It affects females to males at a ratio of 10:1. While the symptoms of IC often mimic a urinary tract infection (UTI), the urine culture of patients with IC will be negative since the condition is caused by inflammation, not an infection. 

IC does not improve with antibiotics, but there are other oral medications that can alleviate the symptoms. Pelvic floor physical therapy and biofeedback can also be helpful. 

STIs

Sexually transmitted infections (STIs), including chlamydia, gonorrhea and genital herpes, can also cause dysuria. 

In males, chlamydia and gonorrhea can also cause penile discharge. In females, chlamydia and gonorrhea can also cause:

  • Fever
  • Pelvic pain
  • Vaginal discharge

Genital herpes typically causes a painful genital rash that can look like small raised red bumps or clear blisters. 

A urine sample or vaginal swab can be used to test for gonorrhea and chlamydia. Genital herpes is diagnosed by performing a viral culture on a swab of the genital rash.

Acute prostatitis

Acute prostatitis is an infection of the prostate gland that often occurs when bacteria seep out of the urinary tract and into the prostate. Symptoms of prostatitis include: 

  • Dysuria
  • Fever
  • Pain with ejaculation
  • Pain in the pelvis, lower back or rectum
  • Urinary frequency

Prostatitis is most common in males ages 35-50. It is typically treated with oral antibiotics and medications that alleviate prostate symptoms.

Vaginosis

Vaginosis occurs when there is a vaginal infection. Yeast, bacteria or viruses can cause vaginosis. Females often experience dysuria with vaginosis that mimics symptoms of a UTI. 

Performing tests on a vaginal swab and a urine sample can help determine whether the painful urination is caused by an infection in the urinary tract or the vagina. 

Vaginosis can also cause:

  •  Abnormal vaginal discharge
  • Fever
  • Foul-smelling discharge
  • Pelvic pain

The treatment of vaginosis depends on what organism is causing the infection.

Kidney stones

Kidney stones are deposits of minerals that form inside the kidney. When the stones get stuck in the small vessels of the kidney, this can cause severe pain in your back, side, groin or stomach.

Other symptoms of kidney stones include:

  • Blood in the urine
  • Cloudy urine
  • Dysuria
  • Foul-smelling urine
  • Inability to urinate
  • Nausea and vomiting
  • Urinary urgency or frequency

Typically, a kidney stone will pass on its own. Drinking lots of water can help move it. Sometimes surgery or other types of treatment are required to remove or break up the kidney stone.

FAQs about painful urination

Here are some common questions about why it hurts to pee. 

What is dysuria? 

Dysuria is the medical term for painful urination. It is typically a symptom of an underlying infection or other medical condition and should be evaluated by a healthcare provider. 

Does painful urination mean kidney problems?

No, there can be many underlying causes of dysuria; it does not always indicate a kidney problem. If you are experiencing symptoms of painful urination, it is best to see a healthcare provider to determine the underlying cause. 

Can painful urination go away on its own?

Yes, sometimes painful urination can go away without treatment. But it is always best to get an evaluation, particularly if you are having other symptoms such as pain, urinary frequency or abnormal discharge. 

Visit an urgent care to treat painful urination

If you are experiencing dysuria, it is best to see a healthcare provider as soon as possible to prevent further complications. The urgent care centers through our healthcare partners are a great place to get an evaluation and treatment immediately without long waits. Find a location near you to just walk in or save your spot online for immediate care 365 days a year. 

Sources: 

  1. https://www.mayoclinic.org/symptoms/painful-urination/basics/causes/sym-20050772
  2. https://my.clevelandclinic.org/health/diseases/15176-dysuria-painful-urination
  3. https://www.cdc.gov/antibiotic-use/uti.html
  4. https://www.cdc.gov/std/mgen/stdfact-Mgen.htm
  5. https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357
  6. https://www.urologyhealth.org/urology-a-z/i/interstitial-cystitis
  7. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate#prostatitis
  8. https://www.kidney.org/atoz/content/kidneystones

Written by Sarah Thebarge, Physician Assistant