Dysuria is painful or uncomfortable urination, typically a sharp, burning sensation. Some disorders cause a painful ache over the bladder or perineum. Dysuria is an extremely common symptom in women, but it can occur in men and can occur at any age.
Dysuria results from irritation of the bladder trigone or urethra. Inflammation or stricture of the urethra causes difficulty in starting urination and burning on urination. Irritation of the trigone causes bladder contraction, leading to frequent and painful urination. Dysuria most frequently results from an infection in the lower urinary tract, but it could also be caused by an upper urinary tract infection.
A number of conditions can cause painful urination (dysuria). In women, urinary tract infections are a common cause of painful urination. In men, urethritis and certain prostate conditions are frequent causes of painful urination. Medical conditions and external factors that can cause painful urination to include bladder stones, chlamydia trachomatis, cystitis, drugs, genital herpes, gonorrhea, having a recent urinary tract procedure performed, kidney infection (pyelonephritis), kidney stones, prostatitis, sexually transmitted diseases, soaps other personal care products, urethral stricture, urethritis, urinary tract infection (UTI), vaginitis, yeast infection (vaginal).
Treatment is directed at the cause. Many clinicians do not treat dysuria in women without red flag findings if no cause is apparent based on examination and the results of a urinalysis. If treatment is decided upon, a 3-day course of trimethoprim/sulfamethoxazole or trimethoprim alone is recommended. Because they can cause tendinopathy, fluoroquinolones should not be used for uncomplicated urinary tract infections (UTIs) whenever possible. Some clinicians give presumptive treatment for a sexually transmitted disease (STD) in men with similarly unremarkable findings; other clinicians await STD test results, particularly in reliable patients. Acute, intolerable dysuria due to cystitis can be relieved somewhat by phenazopyridine 100 to 200 mg orally 3 times a day for the first 24 to 48 hours. This drug turns urine red-orange and may stain undergarments; patients should be cautioned not to confuse this effect with the progression of infection or hematuria. Complicated UTI requires 10 to 14 days of treatment with an antibiotic that is effective against gram-negative organisms, particularly Escherichia coli.
The table below includes the most commonly used ICD-10 codes for dysuria:
Author: Tonoya Ahmed