“Dysuria” is a term that will be unfamiliar to many people. Instead, its translation into the common language will remind many people of an unpleasant situation. By dysuria we ddefine pain or burning during urination, a symptom associated with various conditions of high incidence in the general population, as Dr. Silvia Zandegiacomo De Zorzi, urologist at Humanitas explains.
The symptom may be felt during urination, but not only then: “The patient may experience this painful sensation when passing urine or simply in the presence of urine in the bladder. In other words, pain, discomfort or burning can occur at the same time or independently of urinary flow,” explains Dr. Zandegiacomo De Zorzi.
The organs affected by the disorder referred to as dysuria are different, also depending on the genus: the urethra, that is the channel that connects to the bladder and that transports the urine out of the body, the bladder itself and the prostate, naturally in the male gender.
Gender differences
But what are the causes of this symptom? Patients with pain and burning may be affected by bladder infection, irritating stimulation problems associated with bladder lesions or bladder emptying problems in an obstructive prostatic hypertrophy, leading to urination difficulties.
Among women, very common disorders that can occur with dysuria symptoms are infections of the “lower pathways”: “We refer to infections of the urinary tract, mainly caused by the bladder – more specifically cystitis – and urethra. In the latter case we speak of urethritis. The urethra is in fact the entrance door of bacteria that can go up in the bladder and multiply. Women are more affected than men by the conformation of their urinary tract, with the shorter urethra and often with intestinal dysbiosis. In fact, bacteria often responsible for urinary infections can live normally in the intestine (such as Escherichia Coli) where they perform their function as “good bacteria” and become “aggressive” when they migrate to the urinary tract.
On the other hand, dysuria among men is related to a widespread condition, particularly in the third decade: benign prostatic hypertrophy, “characterized by obstruction and difficulty in emptying the bladder. Dysuria is suggestive in the suspicion of prostatitis, or inflammation of the prostate gland,” adds the doctor.
Some sexually transmitted diseases, such as gonorrhea or chlamydia, or calculi and pyelonephritis, or kidney infection (upper urinary tract), may also be manifested by pain and burning while urinating.
The treatment
In some cases, it is even more compelling to seek medical advice to identify the cause of pain and burning, for example when the patient is pregnant. In any case, in order to get a clearer picture of the situation, it is advisable to look at the other concomitant symptoms: “In case of urinary tract infection or prostatitis there may be an increase in body temperature, macroscopic hematuria, or the visible presence of blood in the urine, and pain at pelvic-perineal level. To define the treatment, it is necessary to make a diagnosis: “Dysuria is worthy of a clinical framework defined by examinations such as urine culture with possible antibiogram, examination of urine, ultrasound of the urinary tract (which must be carried out when the bladder is full) and possibly urinary cytology on three samples”.
After the investigations, the most appropriate treatment is defined as follows: “In case of bladder lesion, endoscopic resection is performed; in case of obstruction due to benign prostatic hypertrophy, a medical therapy is initially defined to resolve dysuria, while in case of urinary tract infection antibiotic therapy is prescribed. This will be chosen in the light of the antibiogram, relative to choosing the most effective therapy against the germ responsible for the infection,” concludes Dr. Zandegiacomo De Zorzi.
