Dysuria is the medical term for pain or discomfort when urinating. Often described as a burning sensation, dysuria most commonly is caused by bacterial infections of the urinary tract. Dysuria is due to infection about 60 percent of the time. All portions of the urinary tract are susceptible to infection, although the causative organisms vary by site. Dysuria is a common symptom in adult women; almost 25 percent of adult women experience an episode of acute dysuria each year. Frequency was a presenting symptom in 93% of dysuria patients compared with 81% of those with no dysuria on presentation.
Dysuria can occur if the tube that carries urine from the bladder to the outside of the body (urethra) becomes irritated or infected. If your child is too young to talk, suspect dysuria if he or she cries each times him or she urinates. Pyelonephritis is an infection that involves the renal parenchyma, calyces, and pelvis of the kidney. Urethritis is an infection of the urethra. Of these three diseases, pyelonephritis is the one most likely to cause fever. The common causes for cystitis are Escherichia coli, Proteus group, and Staphylococcus saprophiticus. In catherized patients, Staphylococcus epidermidis is the most likely cause.
Symptoms that may accompany dysuria also help the clinician determine the underlying cause.
· Urinary hesitation
· Urinary slowness
· Urinary urgency
· Urethral discharge
· Vaginal discharge
· Back pain
· Flank pain
If a urinary tract infection is confirmed or highly suspected, treatment will include the prescription of an antibiotic. If appropriate, pain medications will be administered. If gonorrhea or chlamydia is suspected, your health care provider will provide you with antibiotics to treat these infections, usually even before the lab can confirm the infection. In this case, you will also be instructed to notify any sexual partners for treatment.
To diagnose urethritis and vaginitis, a swab of the infected area may need to be taken and sent for testing. If your doctor suspects you have a kidney infection, a urine sample will be sent to a laboratory to identify the species of bacteria. If you have a fever or appear ill, a blood sample may be tested in a laboratory to check for bacteria in the blood.
A speculum exam can be sometimes be avoided as long as follow up of lab results can be assured, and careful follow up arrangements are made.
Pain or vaginal bleeding , when pregnant will still need both speculum and vaginal exams to evaluate the risk of ectopic pregnancy.