The urge to urinate can sometimes be quite strong and disconcerting, especially when one has been holding off urination for a long time. However, the act of urination itself is normally a painless affair. Sometimes, however, urination may be accompanied by pain or a burning sensation. This is not normal, and one should get the condition examined by a doctor. Medically, a painful, burning sensation during urination is termed as dysuria.
The immediate cause of the burning pain sensation is an inflammation of the structures in the lower urinary tract. Inflammation commonly involves the urethra and the urinary bladder. In men, inflammation may also affect the prostate gland. A burning sensation during urination may also be caused by inflammation of other organs in the genitourinary system. The urethra, bladder and prostate gland may not always be affected.
A burning sensation during urination does not indicate any change in the chemical composition of the urine. The pain sensation arises from an inflammation of the lining of the lower genitourinary tract. Passage of urine through this inflamed tract further irritates the lining and aggravates the pain.
In addition, the pain may get intensified by the contraction of the smooth muscles that line the urinary tract. The burning sensation typically persists for some time (several minutes to hours) after urination. This is because the inflammation in the lining of the urinary tract continues even after the urine has been expelled.
Apart from the burning pain sensation, inflammation of the urinary tract may also present with other signs and symptoms. The nature of these signs and symptoms may indicate the nature of the underlying cause. The following are some of the signs and symptoms that may accompany burning urination.
- Blood in Urine: Hematuria is a medical term used to indicate the presence of blood in urine. Depending on the location, time, and extent of bleeding, the color of the urine in hematuria may be red, orange, brown or dark yellow.
- Urge to urinate: One may feel an urgency to urinate.
- Frequent urination: Frequency of urination may increase.
- Urinary incontinence: Urinary incontinence refers to loss of voluntary control over urination. Incontinence involves unintended or involunatary passage of urine, ranging from a few drops to complete emptying of the urinary bladder.
- Post-micturition dribble: A small amount of urine may continue to dribble out even after completing the act of urination.
- Vesicle tenesmus: After urination, there may be a lingering feeling of incomplete urination and a filled bladder.
- Difficulty in urination: One may find the act of urination difficult due to hesitancy or straining.
- Abnormal discharge: Abnormal urethral or vaginal discharge may occur in women.
- Abnormal urine: The composition of the urine itself may be abnormal in some cases. The urine may become cloudy and have a strong, offensive odor.
- Hematospermia: Hematospermia refers to the presence of blood in semen.
- Lower abdominal pain: Pain may occur in the pelvic and lower abdominal regions.
Read more on signs of bladder disease.
Causes of Burning Urine
A burning sensation during urination can be caused by many different factors. Broadly, these causes can be divided into two categories: infectious causes and non-infectious causes. Most cases of burning urination are due to infectious causes. Bacterial infections of the lower urinary tract are the most common causes of burning urination. Infection of the urethra is most commonly involved.
Bacteria can easily gain entry into the urinary tract through the external meatus and cause infection of the exposed urethra. In time, the infection may also spread to other genitourinary organs. For example, bacterial infection in the urethra may spread upwards to involve the urinary bladder, prostate, ureters, and even the kidneys. Alternatively, infection from the rectum, kidneys, and ureters may expand down towards the urinary bladder and urethra. The spread of infection may occur through the circulating blood or lymph.
Urethritis is a medical term that refers to inflammation of the urethra. Infections caused by a variety of microorganisms, such as bacteria, virus, fungi, and protozoa, can result in urethritis. Parasites (such as schistosomes) can also cause burning urination in endemic areas. Among these microbes, bacterial infections are the most common cause of urethritis. Infection of the urethra may present with a variety of signs and symptoms.
Some of the common signs and symptoms of urethritis include foul-smell in the urine, offensive-smelling discharge in the urine, swelling of lymph nodes in the groin, swelling of the tip of the penis, itching of external genitalia and pain during intercourse or ejaculation. Infections that cause urethritis are often sexually transmitted. Examples of some sexually transmitted diseases that cause urethritis include syphilis, gonorrhea, chlamydia, and genital herpes.
Burning sensation during urination can also result from infection of tissues that lie adjacent to the urinary tract in the pelvic or perineal region.
Read more on urethritis.
Cystitis refers to inflammation of the urinary bladder. Signs and symptoms of cystitis include frequent urination, urinary incontinence, fever, and a constant dull pain in the pelvic or perineal region. The pain may be felt just below the umbilicus, and can radiate out to the sides and the back.
Prostatitis refers to an inflammation of the prostate gland in males. Prostatitis is characterized by frequent and difficult urination.
Vulvovaginitis refers to inflammation of the vulva and vagina in women.
Cervicitis refers to inflammation of the cervix in women.
Epididymo-orchitis refers to inflammation of the epididymis and testes in men.
Trauma caused by circumcision, vigorous sexual activities, urethral catheters, pelvic surgery, and presence of foreign body, can all cause burning sensation during urination.
Irritation and allergic reactions caused by various chemicals present in condoms, spermicides, lubricants, sanitary pads, tampons, cologne, soaps, and toilet paper can also result in burning urination.
Burning urination can also occur due to urinary stones, urethral stricture, and atrophic urethritis.
Bladder problems that may contribute to burning urination include cystitis, bladder stones, and bladder cancer. In women, cystocele may also cause the burning sensation during urination.
In men, prostatitis, benign prostatic hyperplasia and prostate cancer may contribute to burning urination.
Some medications, such as chemotherapeutic drugs, non-steroidal anti-inflammatory drugs, and medications for treating gout, can also cause burning sensation during urination.
Other non-infectious diseases
Burning urination can also be caused by noninfectious systemic, metabolic and autoimmune diseases. Examples include Behcet’s syndrome and Reiter’s syndrome. Dehydration could also be a cause of burning sensation during urination.