Dysuria refers to painful or uncomfortable
urination
Urination is the release of urine from the bladder through the urethra in Placentalia, placental mammals, or through the cloaca in other vertebrates. It is the urinary system's form of excretion. It is also known medically as micturition, v ...
.
It is one of a constellation of ''irritative'' bladder symptoms (also sometimes referred to as lower urinary tract symptoms), which includes
nocturia and
urinary frequency.
Diagnosis
The clinician should also look for physical findings of fever, rash, direct tenderness over the bladder area, and joint pain. Physical findings of increased temperature, increased pulse, low blood pressure in the presence of dysuria can indicate systemic infection. Urological obstruction due to stone or tumor can result in findings of hematuria, decreased urination, and bladder spasms. All these physical findings should be looked for carefully while obtaining history. History regarding recent sexual activity is crucial.
[
Urinalysis is the most useful test to start the work up in a patient of dysuria. Urinalysis positive for nitrite carries a high predictive value of a positive urine culture. Also, urine dipstick showing leukocytes as equal predictive value as the presence of nitrites. When both are present, the predictive value goes even higher. If the patient only has leukocyte esterase or bacteria in the urine, then dysuria may suggest that the patient probably has urethritis.][
]
Differential diagnosis
This is typically described to be a burning or stinging sensation. It is most often a result of a urinary tract infection
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...
. It may also be due to an STD, bladder stones, bladder tumors, and virtually any condition of the prostate
The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
. It can also occur as a side effect of anticholinergic
Anticholinergics (anticholinergic agents) are substances that block the action of the acetylcholine (ACh) neurotransmitter at synapses in the central nervous system, central and peripheral nervous system.
These agents inhibit the parasympatheti ...
medication used for Parkinson's disease
Parkinson's disease (PD), or simply Parkinson's, is a neurodegenerative disease primarily of the central nervous system, affecting both motor system, motor and non-motor systems. Symptoms typically develop gradually and non-motor issues become ...
.
Drugs and irritants
* Chemical irritants, e.g., soaps, tampons, toilet papers
* Drugs, e.g., Cyclophosphamide, Ketamine[
* Capsaicin consumption, e.g., habanero peppers
]
Genital
* Benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...
(male)
* Endometriosis
Endometriosis is a disease in which Tissue (biology), tissue similar to the endometrium, the lining of the uterus, grows in other places in the body, outside the uterus. It occurs in women and a limited number of other female mammals. Endomet ...
(female)
* Prostatic cancer (male)
* Prostatitis (male)
* Vaginitis
Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. Symptoms may include itching, burning, pain, discharge, and a bad smell. Certain types of vaginitis may result in complications during pregnancy.
The three mai ...
(female)
Urinary tract
One of the most common causes of dysuria is urinary tract infection. Urinary tract infections are more common in females than in males due to anatomical differences between them. Females have a comparatively shorter and straight urethra, whereas males have a longer and curved urethra. In females, bacteria can reach the bladder more easily, as they have less distance to travel. Most urinary tract infections are uncomplicated.[ Text was copied from this source, which is available under ]
Creative Commons Attribution 4.0 International License
* Chlamydia
Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear, they may occur only several w ...
* Cystitis
* Hemorrhagic cystitis
* Kidney stone
Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...
s
* Malignancy, i.e., bladder cancer
Bladder cancer is the abnormal growth of cells in the bladder. These cells can grow to form a tumor, which eventually spreads, damaging the bladder and other organs. Most people with bladder cancer are diagnosed after noticing blood in thei ...
, prostatic cancer, or urethral cancer
* Prostatic enlargement, i.e., benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...
(male), prostatic cancer
* Prostatitis (male)
* Pyelonephritis
Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Complications ...
* Sexually transmitted disease
A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, or ...
* Trichomoniasis
Trichomoniasis (trich) is an infectious disease caused by the parasite ''Trichomonas vaginalis''. About 70% of affected people do not have symptoms when infected. When symptoms occur, they typically begin 5 to 28 days after exposure. Symptoms ca ...
* Urethral stricture
* Urethritis
* Urinary schistosomiasis
Schistosomiasis, also known as snail fever, bilharzia, and Katayama fever is a neglected tropical helminthiasis, disease caused by parasitism, parasitic Schistosoma, flatworms called schistosomes. It affects both humans and animals. It affects ...
* Urinary tract infection
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...
(UTI) caused by bacterial infection
Other
* Diverticulitis
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—Diverticulum, diverticula—that can develop in the wall of the large intestine. Symptoms typically include lo ...
* Hypotension
Hypotension, also known as low blood pressure, is a cardiovascular condition characterized by abnormally reduced blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood and is ...
* Mass in the abdomen
* Reactive arthritis
* Acute intermittent porphyria
Acute intermittent porphyria (AIP) is a rare Metabolism, metabolic disorder affecting the production of heme resulting from a deficiency of the enzyme porphobilinogen deaminase. It is the most common of the acute porphyrias.
Signs and symptoms
Th ...
* Hereditary coproporphyria
* Variegate porphyria
Variegate porphyria, also known by several other names, is an autosomal dominant porphyria that can have acute (severe but usually not long-lasting) symptoms along with symptoms that affect the skin. The disorder results from low levels of the enz ...
References
External links
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Symptoms and signs: Urinary system