Dysuria - Causes and Symptoms

Definition

Dysuria is a general difficulty in urinating. Urination can be accompanied by a sharp and burning pain (in this case, however, it would be more correct to speak of stranguria).

Dysuria is a typical symptom of genito-urinary tract infections; it derives from the irritation of the urethra or bladder trigone (region at the base of the bladder, in relation to the vagina in the woman and with the prostate in man).

The inflammation or stenosis of the urethra causes difficulty in starting the urination, as well as burning during the same. The irritation of the trigone causes, instead, contractions of the bladder, with frequent and painful urination.

In most cases, dysuria is the expression of a lower urinary tract infection (responsible for phlogosis of the urethra or bladder), however it can also be present in an upper tract infection (such as pyelonephritis). In the latter case, renal concentration ability is compromised (main reason for frequent urination).

The most frequent causes of dysuria are cystitis and urethritis (secondary to sexually transmitted diseases). Especially in women, this symptom is a consequence of the passage of bacteria (such as Escherichia coli ) from the colon to the bladder.

Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum and Trichomonas vaginalis are among the pathogens acquired through sexual activity that most commonly cause infectious dysuria.

In women, even perineal lesions during vulvovaginitis and herpes simplex virus infections can be painful when exposed to contact with urine (the vulvar lips can be inflamed or ulcerated).

Dysuria can also be attributed to non-infectious inflammatory diseases, such as: prostatitis, interstitial cystitis, neoplasms (generally: bladder or prostate cancer), bladder and kidney stones, exposure to irritants or contact allergies (spermicides, lubricants and latex condoms).

Atrophic vaginitis (post-menopausal), neurological bladder, spondyloarthropathy (eg reactive arthritis or Behçet's syndrome) and intestinal dysbiosis may also predispose to dysuria.

Benign prostatic hypertrophy, tumors, calculi and urinary tract malformations can cause obstructive dysuria. These pathological conditions make the emission of urine difficult due to the presence of an obstacle and typically cause a concomitant reduction in strength and caliber of the mitto.