Rigi10™ Malleable Penile Prosthesis
Also Known As
Painful urination, burning urination, urinary burning, urinary discomfort, stinging urination, urethral pain, urethral burning, urethral discomfort, micturition pain, painful micturition, urodynia
Definition
Dysuria is the sensation of pain and/or burning, stinging, or itching of the urethra or urethral meatus associated with urination.1 It is a prevalent urinary symptom experienced by most people at least once in their lifetime. Dysuria typically occurs when urine comes in contact with the inflamed or irritated urethral mucosal lining. This is exacerbated by and associated with detrusor muscle contraction and urethral peristalsis, which stimulates the submucosal pain receptors, resulting in pain or a burning sensation during urination.2
True dysuria requires differentiation from other symptoms, which can also occur due to pelvic discomfort from various bladder conditions such as interstitial cystitis, prostatitis, and suprapubic or retropubic pain.3 This distressing condition can be caused by multiple underlying factors, including urinary tract infections (UTIs), bladder inflammation, sexually transmitted infections (STIs), or even more serious conditions like kidney stones.4
The discomfort associated with dysuria can significantly impact an individual’s quality of life and necessitates prompt evaluation and appropriate management. Understanding the potential causes and seeking timely medical attention is crucial to alleviate discomfort and address any underlying health concerns associated with dysuria. Treatment varies depending on the etiology.5
Clinical Context
Dysuria is a common presenting symptom in both primary care and urology settings, requiring thorough evaluation to determine its underlying cause.1 The clinical context of dysuria varies widely, as it can be associated with numerous conditions affecting the urinary tract and surrounding structures.
In clinical practice, dysuria is most commonly associated with urinary tract infections (UTIs), which occur in both males and females. Due to anatomical considerations, UTIs are much more common in females than males. In females, bacteria can reach the bladder more easily due to a shorter and straighter urethra than in males.2 Women who use improper wiping techniques, take baths instead of showers, or have certain hygiene practices may predispose themselves to more frequent UTIs due to repeated contamination of the urethral meatus with perirectal and other bacteria.3
Evaluation of dysuria starts with taking a detailed history and performing a thorough physical examination. Associated signs and symptoms of hematuria, suprapubic tenderness, urinary frequency, urgency, fever, chills, nausea, vomiting, low back pain, flank pain, joint pain, or rash require close follow-up.4 Urinalysis is the most useful initial test in a patient with dysuria. Urinalyses positive for nitrites carry a high predictive value of a positive urine culture (75%-95%). Positive leukocytes are also highly predictive but slightly less than nitrites (65%-85%).5
In men, dysuria is frequently caused by urethritis and prostate problems. The most common cause of male urethritis is infectious from sexually transmitted organisms such as Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium.6 Chlamydia is the most commonly identified cause of nongonococcal urethritis (found in about 50% of cases), followed by Mycoplasma genitalium.
Treatment approaches vary depending on the underlying etiology. For bacterial infections, appropriate antibiotics are prescribed based on culture and sensitivity results. For noninfectious causes, treatment focuses on addressing the underlying condition, such as removing irritants, managing prostate conditions, or treating interstitial cystitis.5 Patient education is crucial in preventing recurrent cases of dysuria, particularly for those with recurrent UTIs, STIs, or conditions like atrophic vaginitis.6