What is dysuria?
Pain to urinate, also known as dysuria, is one of the most common symptoms in patients with urinary tract inflammation/infection, states urologist in Delhi.
We consider dysuria any discomfort that arises at the time of urination, be it pain, burning, heaviness, burning or stinging.
In women, the main cause of dysuria is urinary tract infection, more specifically cystitis, which is the name we give to bladder infection.
In men, however, the story is different, at least for those between the ages of 15 and 50, since in this group cystitis is not a common situation. In men, urethritis (inflammation of the urethra) caused by sexually transmitted diseases is a much more frequent cause of urination pain than urinary tract infection.
In this article, the best urologist in Uttam Nagar will talk about the main causes of discomfort or pain during urination among men.
Main causes of dysuria in men
Dysuria usually arises when there is inflammation, whether infectious or not, somewhere in the lower genitourinary tract, which in men is composed of the prostate, bladder, testis, and urethra, explains urologist in Noida.
It is very important to know the main causes of dysuria so as not to fall into the trap of thinking that every pain when urinating is caused by a urinary tract infection. In women, this reasoning may even lead you to make the diagnosis right in most cases, but in young men it is completely wrong.
Next, let’s briefly talk about the 6 most common situations that can cause pain during urination. They are:
- Urinary calculus.
- Benign Prostate Hyperplasia
We call urethritis the inflammation of the urethra, which is the channel that goes inside the penis and drains the bladder urine.
Urethritis is the most common cause of dysuria in young and sexually active men. The main causes of urethritis are gonorrhea and chlamydia, two sexually transmitted bacterial infections.
In both infections, in addition to dysuria, the patient also usually has a purulent urethral discharge, which may arise spontaneously or only when the patient “milks” the penis.
This symptom is the key point that helps differentiate urethritis from urinary tract infection, as cystitis patients do not usually have urethral discharge.
In addition to gonorrhea and chlamydia, urethritis can also be caused by other germs such as Mycoplasma genitalium, Ureaplasma urealyticum, adenovirus and herpes simplex virus.
Inflammation of the urethra may also have non-infectious origin, as in cases of trauma, such as when passing a bladder tube, or irritation by chemicals such as antiseptics or spermicides.
Excessive masturbation may also cause trauma to the urethra and temporary dysuria.
Prostatitis, which is inflammation of the prostate gland, is another common cause of dysuria in men.
Unlike benign prostate hyperplasia and prostate cancer, which are two complications that occur almost exclusively in the elderly, prostatitis can appear in young adults.
Prostatitis can be acute or chronic.
Acute prostatitis is a condition that is usually caused by a bacterium, such as Escherichia coli, Proteus or Klebsiella.
The most common symptoms of acute prostatitis are pain to urinate, fever, chills, urge to urinate all the time, difficulty urinating, pelvic pain, weakness and general malaise.
Conical prostatitis, which is also called chronic pelvic pain syndrome, is a condition of unknown cause that can last for months.
In addition to dysuria, chronic prostatitis can also cause testicular pain, ejaculating pain, difficulty urinating and blood in the sperm.
As noted earlier in the text, urinary tract infection is the leading cause of dysuria in women, but is uncommon in young men.
Urinary tract infection in men usually only occurs in those who have an abnormality of the urinary system, such as urethral stricture, vesicoureteral reflux, or prostate abnormalities that cause urinary flow obstruction.
Therefore, in healthy young men complaining of pain to urinate, cystitis should not be the first or second hypothesis to be considered.
On the other hand, if the patient is already over 50 years old and has a history of benign prostate hyperplasia, the urinary tract infection may be home to dysuria.
The passage of a urinary stone through the urethra can cause injury to the urethra, leading to the onset of dysuria.
Depending on the size of the stone, it can be impacted on the urethra, also causing symptoms such as blood in the urine, difficulty urinating, weak urinary jet and pain in the penis region.
Often the patient can see the moment when the stone passes through the urethra as it comes out in the urine and falls into the toilet. If the stone passage has been very traumatic, the pain to urinate may persist for a few more days.
The epididymis is a structure that is located above the testicles and its function is to store the sperm produced.
Epididymitis is a condition of inflammation of the epididymis, usually caused by infection with the bacterium Chlamydia trachomatis.
Epididymitis may cause pain when urinating, but its most common symptoms are testicular pain and scrotum swelling.
Benign Prostate Hyperplasia
As men get older, their prostate tends to swell, a condition called benign prostate hyperplasia (BPH). About half of patients over 50 have BPH. Already in the age group above 80 years, the rate is greater than 80%.
As the urethra passes inside the prostate, it may become compressed in cases of benign prostate hyperplasia. This compression makes it difficult to pass urine, causing obstruction of urinary flow.
Obstruction can cause pain when urinating because of the patient’s own difficulty passing urine through the urethra, but also because it favors the proliferation of bacteria in the urine, which increases the risk of urinary infection.
In addition to dysuria, the most common symptoms of BPH are weak urinary jet, difficulty initiating urination, urge to urinate all the time, even with low urine volume, urge to urinate, and frequent urination at night., during sleep.