خلاصه
Dysuria refers to discomfort, burning, or sensation of pain during micturition. Patients may also complain of urethral discomfort not associated with micturition. It is a common condition encountered by general practitioners, gynaecologists, and urologists, and can be challenging to diagnose, as it is often present in conjunction with other lower urinary tract symptoms. Dysuria may be external (i.e., urine irritating the inflamed genital organs) or internal (i.e., pain felt in the urethra).
Although infection is the most common cause (urinary tract infection being the most common infection), there is a large list of differential diagnoses that need to be carefully considered, as any infectious or inflammatory condition affecting the genitourinary system may cause dysuria.
Epidemiology
Dysuria accounts for between 5% and 15% of visits to family physicians. [1] It is generally more common in women, with a reported prevalence in women of up to 25% in the US per year, [2] and 27% in the UK per year. [3]
Although dysuria is uncommon in men, incidence increases with advancing age. [4] Lower urinary tract symptoms increase dramatically in men aged >40 years due to bladder outlet obstruction secondary to benign prostatic hyperplasia. [5] Among men of all ages who seek medical advice for urological symptoms, dysuria is present in about 5% of cases. [6]
تشخيص افتراقی
- Common
- Uncommon
-
- Genital herpes simplex virus (HSV)
- Epididymo-orchitis
- Cervicitis
- Schistosomiasis
- Tuberculosis
- Urethral stricture/stenosis
- Honeymoon cystitis
- Instrumentation or catheterisation
- Sexual abuse
- Athletics
- Interstitial cystitis
- Atrophic vaginitis
- Spondyloarthropathies
- Non-infectious prostatitis
- Ketamine bladder
- Urinary fistula
- Prostate cancer
- Bladder cancer
- Renal cancer
- Cervical cancer
- Urethral cancer
- Penile cancer
- Drugs or herbs
- Depression
- Somatisation disorder (urethral hypersensitivity)
