Urination, painful

• urinary tract infection (especially cystitis or urethritis caused by gonorrhea or chlamydia )
• interstitial cystitis in women
• candidal dermatitis or vaginitis
• contact dermatitis or vulvitis
• Reiter's syndrome

Note: There may be other causes of painful urination. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for painful urination, occurring alone or in combination with other problems.

Home Care:
Follow prescribed therapy.

Call Your Healthcare Provider If:

• there is any persistent, painful urination.
• there is drainage or a discharge from the urethra.

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting painful urination in detail may include:

• time pattern
  • When did the painful urination begin?
  • Does the pain occur with each urination?
  • Did it begin suddenly?

• quality
  • Does the pain occur only during urination?
  • Does the pain stop after urination?
  • What kind of pain is it (burning, stinging, cramping)?
  • Is the pain increasing, decreasing, or unchanged?

• location
  • Where is the pain located?
  • Is the pain felt in the pelvis or abdomen?
  • Is the pain in the urethra?
  • Is there back pain ?

• aggravating factors
  • What makes the pain worse?
  • Is the pain worse when sitting?
  • Is the pain worse when standing?
  • Is the pain worse at night?
  • Is the pain worse in the morning?
  • Does the pain occur when passing stools?

• relieving factors
  • What helps relieve the pain?

• other
  • What other symptoms are also present?
    • Is there fever ?
    • Is there drainage or discharge between urinations?
    • Is there an abnormal urine odor ?
    • What color is the urine?
    • Are there any changes in the volume or frequency of urination?
    • Was any blood in the urine noticed?
    • Are there any rashes or itching ?

  • What medications are being taken?
  • Has there been a previous bladder infection ?
  • Are there any allergies ?
  • Have there been any recent injuries?
  • Do you take daily baths or showers?
  • Is bubble bath used? How often?
  • Has there been a recent change in the brand of soap, detergent, or fabric softener?

With previous bladder or kidney infections, a more detailed history and physical are needed and extra laboratory studies may be necessary. In women with a discharge, an examination of the vagina and any discharge is usually necessary.

Diagnostic tests:
A urine culture is usually ordered. A urethral discharge culture or an endocervical culture may be obtained.

Intervention:
Depending on the cause, therapy may range from antibiotics (for infection) to surgery (for persistent, enlarged prostate). If urinary tract infection is confirmed, an antibiotic will be prescribed. If appropriate, pain medications will be administered.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to painful urination, you may want to note that diagnosis in your personal medical record.


This is an illustration of the female urinary tract. The female and male urinary tracts are relatively the same except for the length of the urethra. The positioning in the body and relative size of the organs are also demonstrated.