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Pain when urinating: causes


Pain when urinating The appearance of pain during urination (dysuria) indicates the presence of pathology in one or more organs of the urinary or reproductive system. This phenomenon is more common in women than in men, which is associated with the peculiarities of the anatomical structure of the urogenital system in them.

Urination is the physiological process of urine excretion that forms in the kidneys. The process of formation of primary and secondary urine occurs constantly. In the ureters, it accumulates in the bladder to a certain volume, then from the bladder to the brain impulse comes the urge to urinate. During this process, urine exits the urethra (urethra). Pain during urine output develops due to irritation of the nerve endings of the inflamed bladder mucosa or urethra. This is due to the fact that during cell damage or destruction under the influence of various factors, white blood cells (cells of the immune system) rush into this area. They produce inflammatory mediators of prostaglandins, which increase blood flow in the inflammatory process (hyperemia), tissue edema (plasma release into the intercellular space) and direct irritation of sensitive nerve endings with the development of pain.

Causes of pain when urinating

The appearance of pain during urination is associated with an inflammatory process in the lower urinary system, which develops under the influence of infectious and non-infectious etiological factors.

Infectious causes of pain when urinating

The inflammatory process in the organs of the genitourinary system of a man or a woman is caused by various bacteria. Depending on the location, pain during urination can cause several such inflammatory processes:

  • Cystitis - inflammation that develops in the mucous membrane of the bladder due to the parasitization of bacteria in it. The most pronounced dysuria develops with the localization of the inflammatory process in the region of the Lietho anatomical triangle (the mucosal area located between the openings of the ureters and the urethra in the bladder), because it contains the largest number of sensitive nerve endings.
  • Urethritis is a bacterial inflammation of the urethra, the passage of urine through which during urination causes pain in the form of a burning sensation. It develops more often in women, because anatomically their urethra is shorter than in men.
  • Cervicitis is an inflammatory process in the cervix of a woman.
  • Prostatitis is an inflammation of the prostate gland in men.

Bacterial inflammation of the lower urinary tract causes bacteria, which most often include staphylococci, streptococci, E. coli and Klebsiella. Their development provokes a decrease in local immunity against the background of local hypothermia. There is also a hematogenous route of infection, in which the bacterium enters the bladder or urinary canal along with the blood stream.

Non-infectious causes of pain when urinating

Causes of this group of etiological factors in the development of pain during urination include:

  • Allergic and inflammatory reaction of the mucous membrane of the bladder and urethra as a result of contact irritation with various chemical compounds. These include various hygiene products (shower gel, soap), synthetic underwear, lubricants, condoms or spermicidal lubricants.
  • Autoimmune pathology affecting the mucous membrane of the urinary tract is a rather rare condition in which antibodies to the body’s own tissues are produced as a result of a breakdown of the immune system.
  • Atrophy of the vaginal mucosa in women is the result of a decrease in the level of estrogen (sex hormones produced by the ovaries) in the body after menopause or in violation of hormonal balance. It is characterized by various disorders of the process of urination and the development of dysuria.
  • Oncological pathology - the development of benign or malignant (cancer) tumors in the bladder or urethra. In men, dysuria is often caused by benign (adenoma) prostate cancer or prostate cancer.
  • Foreign body in the bladder - most often in the bladder stones from the kidneys descend down the ureters during urolithiasis, accumulate there and cause the development of pain when urinating. Rarely a foreign body are some types of worms.

The most serious cause of the non-infectious group of the etiological factors of pain during urination is an oncological process, which requires the earliest possible start of treatment.

Symptoms of dysuria, depending on its cause

Depending on the causative factor in the development of pain during urination, dysuria may differ in its nature and associated symptoms:

  • Severe pain, which increases at the end of urination - indicates the inflammatory process in the bladder mucosa, namely in the area of ​​the triangle Leteto. Also, cystitis is characterized by increased urge to urinate, while the amount of urine released is small.
  • Pain at the beginning of urination in the form of a burning sensation indicates a predominant lesion of the mucous membrane of the urinary canal. The inflammatory process usually extends over time to the bladder mucosa. In this case, the pain accompanies the whole process of urination.
  • The development of symptoms of general intoxication of the body against the background of pain during urination indicates the development of a purulent bacterial inflammatory process in the organs of the urinary system. Such symptoms include general weakness, aching muscles and joints, headache, fever.
  • The presence of deterioration of urine outflow in conjunction with dysuria in men is the result of inflammation of the prostate gland or prostate adenoma, which squeezes and partially clamps the urethra directly below the bladder.
  • Pain when urinating in combination with dyspareunia (pain in the vagina during intercourse) in women is a manifestation of cervicitis or atrophy of the vaginal mucosa.
  • The appearance of blood in the urine during urination and dysuria is a serious symptom of a possible oncological process. Also, blood can appear in urolithiasis due to damage to the bladder mucosa by the sharp edges of the stones. In the case of the development of an oncological process, pain becomes permanent over time and tends to significantly increase its intensity.

The nature of pain during urination, and the accompanying symptoms will help to suspect the cause of dysuria, but it is possible to determine it accurately only after additional examination.

Diagnosis of causes

Additional diagnostics, which allows you to reliably determine the cause of pain during urination, includes several methods of laboratory and instrumental examination, which include:

  • Urinalysis is the most commonly prescribed study that helps significantly narrow the scope of follow-up examination. The presence of protein and leukocytes in the urine sediment indicates a bacterial inflammatory process in the lower urinary tract. In urolithiasis, microcrystals appear in the urine sediment, which take part in the formation of stones.
  • A blood test - helps to establish whether there is an inflammatory process in the body to increase the number of leukocytes and increase the ESR (erythrocyte sedimentation rate).
  • Ultrasound examination of the kidneys and bladder - an informative method of visualization of foreign bodies and stones in urolithiasis.
  • Cystoscopy - a visual study of the state of the inner surface of the walls of the bladder and urethra is performed. This technique is performed using an optical cystoscope device that is inserted into the bladder. If an oncologic process is suspected, a biopsy is performed during cystoscopy - taking a small piece of tissue in vivo for subsequent examination under a microscope in a laboratory and verifying the histological type of a benign or malignant neoplasm.
  • Urography with a contrast agent - a special contrast agent is injected into the cavity of the bladder, which does not allow X-rays to pass through. After X-ray, this makes it possible to visualize changes in the shape and size of the bladder.
  • Computed tomography is a modern X-ray examination, in which a layer-by-layer scanning of the body part under examination is performed. Due to the high resolution of this research method, it is possible to determine even small changes in the anatomical integrity and structure of the tissues of the bladder or urethra.
  • Magnetic resonance imaging - the principle of the technique is the same as in computed tomography, but for visualization, instead of X-ray exposure, a magnetic field is used.

The choice of the method of additional examination during the diagnosis of the causes of pain during urination is made by the doctor in each case individually, based on the symptoms and possibilities of the medical institution.

Pain when urinating: treatment

The main goal of dysuria therapy is to eliminate pain during urination. To do this, first of all, all therapeutic measures are aimed at eliminating the effect of the causative factor with the help of various drugs or procedures:

  • Antibiotics are used to kill bacterial infections in infectious cystitis, urethritis, inflammation of the prostate gland or cervicitis. They use broad-spectrum agents that are active against most of the causative agents of these diseases — cephalosporins, fluoroquinolones, or a group of semi-synthetic penicillins.
  • Anti-inflammatory drugs - block the synthesis of the main mediators of inflammation of prostaglandins, due to this they reduce the severity of inflammation and the intensity of pain during urination.
  • Hormonal agents for replacement therapy in the case of vaginal mucosa atrophy. Used estrogen derivatives, which are contained in oral contraceptive preparations.
  • Diuretic drugs - are used if necessary, forced urine excretion, due to which the pathological factor is washed out from the walls of the bladder or urethra. This group of drugs is prescribed by the doctor only individually after the examination.
  • Surgical removal of a malignant or benign neoplasm followed by chemotherapy (agents that inhibit the growth and development of tumor cells) or radiation therapy.
  • Remove small cameos from the bladder cavity using a cystoscope or surgically.
  • Adenoma resection - surgical removal of part of the prostate gland with its increase due to the development of a benign tumor.

The appearance of pain during urination is a manifestation of the pathological process in the organs of the urinary system. By itself, the pain does not go away, and in most cases it tends to gradually increase. In order to get rid of dysuria, it is necessary to consult a urologist, who after an appropriate additional examination will determine the cause of such pain. This will provide an opportunity to conduct etiotropic treatment - therapy aimed at eliminating the impact of the causative factor on the bladder mucosa or urethra.

| 13 March 2015 | | 684 | Diseases of the genitourinary system
Leave your feedback

Spiritdove: i have no problem talking to my doc. I been getting uti about every 3 month.s results look ok. bit high in ascorbic acids so trying azo and squats and im menopausal

Sardarni Jagdeep Kaur: Hello Abraham. Nice to listen your video. I don't know alot of English but I understand easy speaking English. I have urine incontinence. I can't understand that what you speak about. I read all comments. I really wants to do that you told. Please help me. Tell me in written or something that your convenience.

Zoe Lawrence: So I had to take a urinalysis for my job and found out I have white blood cells in my urine, so I’ve been drinking a lot of water and now my urine is a really light yellow color is it possible that when I return for another urinalysis I won’t have white blood cells in my urine ?