View source for Dysuria

{{Short description|Painful or uncomfortable urination}}
{{Infobox medical condition (new)
| name            = Dysuria
| synonyms        =
| image           =
| caption         =
| pronounce       =
| field           = [[Urology]], [[Infectious disease (medical specialty)|infectious disease]]
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           =
| causes          =
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       =
| frequency       =
| deaths          =
}}
'''Dysuria''' refers to painful or uncomfortable [[urination]].<ref>{{MeshName|Dysuria}}</ref><ref name="MengelSchwiebert2005">{{cite book|author1=Mark B. Mengel|author2=L. Peter Schwiebert|title=Family medicine: ambulatory care & prevention|url=https://books.google.com/books?id=XvLo7xvmFo0C&pg=PA121|access-date=23 June 2011|year=2005|publisher=McGraw-Hill Professional|isbn=978-0-07-142322-9|pages=121–}}</ref>

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.<ref name=statspe/>

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]].<ref name=statspe/>

==Differential diagnosis==
This is typically described to be a burning or stinging sensation. It is most often a result of a [[urinary tract infection]]. It may also be due to an [[Sexually transmitted disease|STD]], [[bladder stones]], [[bladder tumors]], and virtually any condition of the [[prostate]]. It can also occur as a side effect of [[anticholinergic]] medication used for [[Parkinson's disease]].{{cn|date=April 2021}}

===Drugs and irritants===
* Chemical irritants, e.g., soaps, tampons, toilet papers
* Drugs, e.g., [[Cyclophosphamide]], Ketamine<ref name=statspe/>
* Capsaicin consumption, e.g., [[habanero]] peppers

===Genital===
* [[Benign prostatic hyperplasia]] (male)
* [[Endometriosis]] (female)
* [[Prostatic cancer]] (male)
* [[Prostatitis]] (male)
* [[Vaginitis]] (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.<ref name=statspe>{{cite journal | vauthors = Mehta P, Reddivari A | title = Dysuria | journal = Statpearls| date = 2020 | pmid =  31751108}}[[File:CC-BY icon.svg|50px]] Text was copied from this source, which is available under a [https://creativecommons.org/licenses/by/4.0/ Creative Commons Attribution 4.0 International License].</ref>
* [[Chlamydia infection|Chlamydia]]
* [[Cystitis]]
* [[Hemorrhagic cystitis]]
* [[Kidney stone]]s
* Malignancy, i.e., [[bladder cancer]], [[prostatic cancer]], or [[urethral cancer]]
* Prostatic enlargement, i.e., [[benign prostatic hyperplasia]] (male), [[prostatic cancer]]
* [[Prostatitis]] (male)
* [[Pyelonephritis]]
* [[Sexually transmitted disease]]
* [[Trichomoniasis]]
* [[Urethral stricture]]
* [[Urethritis]]
* Urinary [[schistosomiasis]]
* [[Urinary tract infection]] (UTI) caused by bacterial infection

===Other===
* [[Diverticulitis]]
* [[Hypotension]]
* Mass in the abdomen
* [[Reactive arthritis]]
* [[Acute intermittent porphyria]]
* [[Hereditary coproporphyria]]
* [[Variegate porphyria]]

==References==
{{Reflist}}

== External links ==
{{Medical resources
|  ICD10          = {{ICD10|R|30|0|r|30}} 
|  ICD9           =  {{ICD9|788.1}} 
|  ICDO           =
|  OMIM           =
|  DiseasesDB     = 18003
|  MedlinePlus    = 003145
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID         = D053159 
}}

{{Urinary system symptoms and signs}}

{{Authority control}}
[[Category:Symptoms and signs: Urinary system]]