Conditions Besides Bladder Infections That Cause Dysuria (Painful Urination)
What causes pain when urinating? While most people associate painful urination with bladder infections, there are other conditions that can cause dysuria. If you’re experiencing dysuria, here are other conditions that may be causing your pain when urinating.
Mycoplasma
Mycoplasmas 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 dysuria, vaginal discharge, pain with sex, and abnormal vaginal bleeding. Symptoms of mycoplasma in males include dysuria, urethral swelling, and penile discharge.
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 them from passing the infection back and forth.
Interstitial Cystitis
Interstitial Cystitis (IC) is a condition that causes chronic inflammation in the bladder. IC can cause frequent urination, dysuria, pelvic pain, pain with sex, and a 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 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.
STI’s
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 vaginal discharge, pelvic pain, and a fever. 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 seeps out of the urinary tract and into the prostate. Symptoms of prostatitis include dysuria, urinary frequency, a fever, pain with ejaculation, and pain in the pelvis, low back, or rectum.
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. Vaginosis can be caused by yeast, bacteria, or viruses. 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 in the vagina.
Vaginosis can also cause abnormal vaginal discharge, foul-smelling discharge, pelvic pain, or a fever. The treatment of vaginosis depends on what organism is causing the infection.
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Sources:
https://www.mayoclinic.org/symptoms/painful-urination/basics/causes/sym-20050772
https://www.webmd.com/a-to-z-guides/mycoplasma-infections
https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357
Written by Sarah Thebarge, Physician Assistant