Dysuria is the medical term for pain or discomfort while urinating. Bacterial infections of the urinary tract are the most common cause of dysuria, which is defined as painful urination, that is, a burning sensation while urinating. In the absence of infection, a burning sensation may occur during urination due to many reasons. The burning sensation in the urine at the beginning of urination, at the end of the urination and after it ends or if it is continuous can give us an idea about the cause of the burning and the area where it originates. In addition, other complaints accompanying the burning (bleeding, fever, need to urinate frequently, etc.) contribute to the diagnosis. Burning in urination is more common in women than men. Pain accompanying dysuria, the need to urinate frequently, and pain in the groin indicate that the event is mostly due to infection. In addition, the possibility of bladder cancer in men should be kept in mind for middle-aged smokers who only have burning at the end of urination. A bladder infection in men over 50 is often associated with an enlarged prostate or prostate infection.
Causes of burning in urine
– Causes of urinary obstruction: In diseases that cause obstruction in the urinary tract, such as urethra (urinary tract) stricture, prostate enlargement, there may be a burning complaint while urinating. Prostate enlargement seen in men with increasing age is the most common cause of urinary burning and obstruction. Along with dysuria, these patients have complaints of intermittent urination, forked urination, and urinary incontinence. In case of bladder dysfunction and vesicoureteral reflux (VUR) in children, urinary burning may be seen.
-Urological Cancers: Kidney, Bladder and prostate cancer, Urethra cancer (urinary tract cancer). Dysuria may present as an early sign of bladder cancer. Bladder cancer should be kept in mind in a male smoker if there is no urinary tract infection, burning in the urine and microscopic or visible bleeding in the urine.
-Stone disease: Stone diseases (kidney, bladder and urinary tract stones with or without obstruction). They cause dysuria by irritating and irritating urinary tract cells. urinary stone-forming substances (calcium, uric acid and oxalate etc.) excretion is high.
– Among other non-infectious causes: Rheumatic diseases such as Reiter’s syndrome, Behçet’s disease, Vasculitis, glomerulonephritis, Diabetes (diabetes), Pregnancy, some drug side effects may also cause dysuria. Dysuria may also be seen. Dysuria can be seen in the last stages of pregnancy. Dysuria may occur in cases of allergies and irritation due to activities such as riding or cycling, soaps, perfumes and other personal care products. In postmenopausal women, tissue growth (carincle) in the outer urinary opening and burning in the urine may occur due to its obstruction.
-Allergic conditions: Dysuria can be seen in allergic conditions to certain foods, chemicals, herbal and medical drugs.
2- Causes due to infection
-Cystitis: It is the most common cause of urinary burning, especially in women. Cystitis is very common in women between the ages of 20 and 50. It usually starts when bacteria enter the opening where urine comes out (urethra) during sexual intercourse. When bacteria enter the urinary tract of a woman, the distance is short, so they quickly reach the bladder, where they multiply and cause cystitis.
– Kidney infection (Pyelonephritis): It is a relatively severe clinical picture that goes along with urination burning, flank pain, fever, the need to go to the toilet frequently, and nausea.
Gonorrhea (Urethritis): It is accompanied by burning in urination, discharge and itching in the urethra. The type of bacteria can be predicted by the color of the discharge. It is usually a sexually transmitted infection.
Prostatitis: Prostate infection, burning in urination, frequent urination, intermittent urination, forked urination, pain in the genital area.
-Epididymitis and Epididymo-Orchitis: Dysuria is a testicular infection that manifests itself with pain, swelling, redness, and fever in the testicles.
– Vaginitis: It manifests itself with vaginal discharge, itching, burning and pain in urination. Vaginitis may be due to fungi and bacteria. After menopause, burning in the urine may occur without signs of infection due to hormone withdrawal.
History, physical examination, blood and urine tests, and urine culture are the first steps of approaching a patient with urinary burning. Even a simple urinalysis can give an idea about many diseases. Since approximately 60% of the causes that cause burning in the urine are due to infections, infection-related tests should be considered in the foreground in these investigations. If there is no sign of infection, then the disease and causes that may cause burning in the urine are investigated. According to the information to be obtained from here, urine rate measurement, ultrasonography, tomography (CT) and magnetic resonance (MR) may be required.
The treatment of burning in urination is directed towards the underlying cause. Treatment aimed at reducing the complaint of dysuria alone can only be given some drugs to reduce the complaints if the cause of dysuria cannot be completely eliminated. Depending on the cause of the dysuria, it responds well to treatment within a few days. Complaints may take longer if the underlying cause is difficult or complex to determine. To help prevent dysuria caused by cystitis or pyelonephritis, it may be recommended to drink several glasses of water each day.