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This symptom usually reflects lower urinary tract infection (UTI) is a common disorder, especially in women. Introduction: Dysuria results from lower urinary tract irritation or inflammation, which stimulates nerve endings in the bladder and urethra. The onset of pain provides clues to its cause.
Pain just before voiding usually indicates bladder irritation or distention, whereas pain at the start of urination typically results from bladder outlet irritation. Pain at the end of voiding may signal bladder spasms; in women, it may indicate vaginal candidiasis.
MEDICAL CAUSES
• Appendicitis. Occasionally, appendicitis causes dysuria that persists throughout voiding and is accompanied by bladder tenderness.
• Bladder cancer. In this predominantly male disorder, dysuria throughout voiding is a late symptom associated with urinary frequency and urgency, nocturia, hematuria, and perineal, back, or flank pain.
Cystitis. Dysuria throughout voiding is common in all types of cystitis, as are urinary frequency, nocturia, straining to void, and hematuria. Bacterial cystitis, the most • Diverticulitis. Inflammation near the bladder may cause dysuria throughout voiding. Other effects include urinary frequency and urgency, nocturia, hematuria, fever, abdominal pain and tenderness, perineal pain, constipation or diarrhea and, possibly, an abdominal mass.
• Paraurethral gland inflammation. Dysuria throughout voiding is accompanied by urinary frequency and urgency, diminished urine stream, mild perineal pain and, occasionally, hematuria in this disorder.
• Prostatitis. Acute prostatitis commonly causes dysuria throughout or toward the end of voiding as well as a diminished urine stream, urinary frequency and urgency, hematuria, suprapubic fullness, fever, chills, fatigue, myalgia, nausea, vomiting, and constipation.
• Pyelonephritis (acute). More common in females than in males, this disorder causes dysuria throughout voiding. Other features include persistent high fever with chills, costovertebral angle tenderness, unilateral or bilateral flank pain, weakness, urinary urgency and frequency, nocturia, straining on urination, and hematuria. Nausea, vomiting, and anorexia may also occur.
Reiter's syndrome. In this predominantly male disorder, dysuria occurs 1 to 2 weeks after sexual contact. Initially, the patient has a mucopurulent discharge, urinary urgency and frequency, meatal swelling and redness, suprapubic pain, anorexia, weight loss, and low-grade fever. Hematuria, conjunctivitis, arthritic symptoms, a papular rash, and oral and penile lesions may follow.
• Urethral syndrome. Occurring in sexually active women, this syndrome mimics urethritis. Dysuria throughout voiding may occur with urinary frequency, diminished urine stream, suprapubic aching and cramping, tenesmus, and low back and unilateral flank pain. In the absence of pyuria, symptoms will usually resolve without intervention.
• Urethritis. Primarily found in sexually active males, this infection causes dysuria throughout voiding. It's accompanied by a reddened meatus and a copious, yellow, purulent discharge (gonorrheal infection) or a white or clear mucoid discharge (nongonorrheal infection).
• Urinary obstruction. Outflow obstruction by urethral strictures or calculi produces dysuria throughout voiding. (In a complete obstruction, bladder distention develops and dysuria precedes voiding.) Other features are diminished urine stream, urinary frequency and urgency, and a sensation of fullness or bloating in the lower abdomen or groin.
• Vaginitis. Characteristically, dysuria occurs throughout voiding as urine touches inflamed or ulcerated labia. Other findings include urinary frequency and urgency, nocturia, hematuria, perineal pain, and vaginal discharge and odor.
OTHER CAUSES
• Chemical irritants. Dysuria may result from irritating substances, such as bubble bath salts and feminine deodorants; it's usually most intense at the end of voiding. Spermicides may cause dysuria in both sexes as well as urinary frequency and urgency, a diminished urine stream and, possibly, hematuria.
• Drugs. Monoamine oxidase inhibitors and metyrosine can cause dysuria.
Investigations:
1.urinalysis
2.cystoscopy.
Prevention:
1. Drink at least 10 glasses of fluid, especially water, daily. This helps flush bacteria from the urinary tract.
2. Empty your bladder completely every 2 to 3 hours or as soon as you feel the urge to urinate.
3. Wear cotton underpants, which allow better ventilation and absorption than synthetic ones.
4. Take showers instead of baths. If you must bathe, don't use bubble bath salts, bath oil, perfume, or other chemical irritants in the water. Also, avoid using feminine deodorants, douches, and similar irritants. Avoid using menstrual pads, which may also act as irritants.
5. Urinate before and after intercourse.
6. Follow an acid-ash diet. Include meats, eggs, cheese, nuts, prunes, plums, whole grains, and especially cranberry juice in your daily intake. These foods acidify the urine, which helps decrease bacterial growth. Avoid foods containing baking soda or powder, such as most baked goods.
7. Avoid coffee, tea, and alcohol, which tend to irritate the bladder.
8. Seek medical help for any unusual vaginal discharge, which suggests infection.
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