Dysurie

Dysurie, or dysuria, is the medical term for painful or difficult urination. It is a common symptom that can occur with a range of urinary and genital conditions.

Most often it results from a urinary tract infection, urethritis, or prostatitis in men. Other frequent causes include vaginal infections, sexually transmitted infections, bladder or kidney stones, and chemical irritation from soaps, spermicides, or catheters. Less common causes include inflammatory conditions such as interstitial cystitis, urethral strictures, vaginal irritation, or malignancy. Dysurie may be accompanied by burning, urgency, frequency, blood in the urine, or lower abdominal or back pain. In women, it may occur with vulvovaginitis or pelvic inflammatory disease; in men, prostatitis or epididymitis can be culprits.

Evaluation begins with history and physical examination, followed by urinalysis and sometimes urine culture. Tests for sexually transmitted infections are considered if indicated by symptoms or risk factors. Pregnancy testing or pelvic examination may be performed in women of childbearing age. Imaging (ultrasound or CT) or cystoscopy is reserved for persistent symptoms, suspicion of stones, obstruction, or malignancy.

Treatment targets the underlying condition. Urinary tract infections or prostatitis are typically treated with antibiotics; STIs require specific antimicrobials. Analgesics such as phenazopyridine may provide temporary relief of dysuria but do not treat infection. Patients should increase fluid intake, avoid irritants, and seek care if symptoms worsen or red-flag symptoms appear.

Outlook is generally favorable with prompt treatment; some chronic or recurrent cases require further evaluation for conditions such as interstitial cystitis or urethral stricture.