Merck Manual

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Some Causes and Features of Painful Urination

Some Causes and Features of Painful Urination


Common Features*



Usually in women and girls

A frequent and urgent need to urinate

Getting up at night to urinate

Sometimes blood in the urine or foul-smelling urine

A doctor's examination

Tenderness and swelling in a testis

Possibly frequent urination or a discharge from the urethra

Sometimes fever or nausea

A doctor's examination

Sometimes urinalysis

A tender prostate detected during a digital rectal examination

Often fever, difficulty starting urination, frequent urination, the need to urinate during the night, and burning or pain during urination

Sometimes blood in the urine

Often symptoms of a long-standing blockage in the urinary tract (including a weak urine stream, difficulty passing urine, or dribbling at the end of urination)

Urinalysis and urine culture

Usually a visible discharge from the urethra in men

Sometimes a discharge from the vagina in women

In people who have recently had unprotected intercourse

STD testing

A discharge from the vagina

Often redness in the genital area

A doctor's examination, including examination of a sample of the discharge under a microscope

Often a cervical discharge

History of unprotected intercourse

STD testing

Disorders that cause inflammation

General or bodywide symptoms (including body pain and joint pain) that develop before urination becomes painful

Sometimes sores on the skin, mouth, eyes, or genital area, including inside the vagina

STD testing

Sometimes blood tests to check for these connective tissue disorders

Contact with a substance that irritates the area or causes an allergic reaction (such as a spermicide, lubricant, or latex condom)

Sometimes redness in the genital area

In people who have been exposed to a substance that could cause irritation or an allergic reaction

Only a doctor's examination

More common among women

A frequent and urgent need to urinate

Long-standing symptoms

Urinalysis and urine culture

Other disorders

Atrophic vaginitis or urethritis (thinning of tissues in the vagina or urethra)

In postmenopausal women

Vaginal dryness

Often pain during intercourse

A discharge from the vagina

Changes in the interior of the vagina (it becomes smooth and pale)

Only a doctor's examination

Long-standing symptoms, such as a weak urine stream or difficulty starting urination

If prostate cancer is suspected, a blood test to measure PSA levels

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.

† Infectious organisms that commonly cause painful urination include sexually transmitted organisms Overview of Sexually Transmitted Diseases (STDs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted diseases may be caused... read more Overview of Sexually Transmitted Diseases (STDs) (such as those that cause gonorrhea, chlamydial infection, and trichomoniasis) and bacteria that are not sexually transmitted, mostly Escherichia (E.) coli.

‡ This cause is rare.

PSA = prostate-specific antigen; STD = sexually transmitted disease.