Dysuria refers to discomfort, burning, or sensation of pain during micturition. Patients may also complain of urethral discomfort not associated with micturition. Dysuria may be external (i.e., urine irritating the inflamed genital organs) or internal (i.e., pain felt in the urethra).
Although urinary tract infection is the most common cause, any infectious or inflammatory condition affecting the genitourinary system may cause dysuria.
Dysuria is a common presentation in primary care. It is generally more common in women, with a reported prevalence in women of up to 25% in the US per year and 27% in the UK per year. Approximately 1 million urinary tract infections are treated every year in US emergency departments, with a female:male ratio of 6:1.
Although dysuria is uncommon in men, incidence increases with advancing age. Lower urinary tract symptoms increase dramatically in men ages >40 years due to bladder outlet obstruction secondary to benign prostatic hyperplasia. Among men of all ages who seek medical advice for urologic symptoms, dysuria is present in about 5% of cases.
- Vulvovaginitis (including bacterial vaginosis)
- Acute prostatitis
- Benign prostatic hyperplasia
- Local irritants
- Genital herpes simplex virus (HSV)
- Urethral stricture/stenosis
- Instrumentation or catheterization
- Sexual abuse
- Interstitial cystitis
- Atrophic vaginitis
- Noninfectious prostatitis
- Ketamine bladder
- Urinary fistula
- Prostate cancer
- Bladder cancer
- Renal cancer
- Cervical cancer
- Urethral cancer
- Penile cancer
- Drugs or herbs
Kasra Saeb-Parsy, BSc, MBBS, AFHEA, FRCSEd (Urol)
Cambridge University Hospitals NHS Foundation Trust
Anglia Ruskin University
KS-P declares that he has no competing interests.
Elaine Lee, MBBS, MA, FRCS (Urol)
Functional Urology Fellow
EL declares that she has no competing interests.
Kasra Saeb-Parsy and Elaine Lee would like to acknowledge Dr Vincent J. Gnanapragasam, a previous contributor to this topic.
VJG declares that he has no competing interests.
Robert Pickard, MD, FRCS (Urol)
Professor of Urology
Institute of Cellular Medicine
Newcastle upon Tyne
RP has received funding from the UK NHS (NIHR) to undertake commissioned reviews of treatment for benign prostatic enlargement.
George Martin, MD
Department of Urology
GM declares that he has no competing interests.
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