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Urinary pain

Urinary pain is often a symptom of a urinary tract infection such as cystitis, but it can also be caused by a reaction to an irritant, such as perfumed soap. It’s more likely to affect women than men, but any inflammation of the kidneys or bladder can lead to it.

  • Often causes a stinging or burning sensation
  • Many factors may cause it, including sexually transmitted infections (STIs)
  • Antibiotics are often needed for treatment

If you would like to book an appointment to speak to a doctor about urinary pain online, you can do so via our online video consultation service. Our GPhC-registered clinicians can issue advice about managing symptoms and how you can treat them from 9.30am-4.30pm, Monday to Friday. They can also provide prescriptions and referral to specialists where suitable. 

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Possible causes

What causes urinary pain?

Urinary pain is most commonly caused by a lower urinary tract infection. In most cases, these infections are caused by bacteria, and can occur in the urethra, the bladder or the kidneys. It’s thought that women are more likely than men to experience urinary tract infections, as the urethra is shorter in comparison. 

Men may experience urinary pain as a consequence of developing prostatitis, in which the prostate gland becomes inflamed and causes a burning or stinging sensation when urinating. 

Certain STIs, such as genital herpes, gonorrhoea and chlamydia, can also result in urinary pain. If you think you may have an STI, you should make an appointment to see your GP or with a sexual health (GUM) clinic for testing. 

Upper tract infections can involve the kidneys, when bacteria travels upwards from the bladder. They can often occur during pregnancy, in people with diabetes and also men with enlarged prostates. Urethritis (the inflammation of the urethra) and vaginitis (the inflammation of the vagina) are symptoms of lower tract infections. The three most common infections leading to vaginitis are candidiasis (a type of fungal infection), trichomoniasis (a sexually transmitted parasite) and bacterial vaginosis.

Although rare, cancer of the bladder or prostate can trigger urinary pain. 

Diagnosing urinary pain

Your doctor will assess your medical history, and in some cases conduct an examination and perform tests. They will ask you about the nature of the pain, including how long it lasts, how severe it is, and when you first noticed it. They will also look to establish if any abdominal pain is present, which could indicate a more serious condition such as appendicitis.

Other symptoms that should be noted are:

  • Fever (which may indicate an infection)
  • Discharge from the vagina or urethra (usually a sign of a genital tract infection)
  • Odour from the genitals (which could indicate a bacterial infection)
  • Disrupted flow (indication of an obstruction)
  • Sense of urgency to urinate, and frequent urination (a sign of bladder irritation)

A doctor will also explore the possibility of pregnancy, and if you have previously had a urinary tract infection. It is also important that a doctor is informed about recent sexual history, and whether contraception was used.

In many cases examination will not be required, if a urinary tract infection is strongly suspected. However, a doctor may want to have a look at the stomach for signs of tenderness, the genitals for possible discharge, and the prostate in men to see if it is enlarged.

There are several different tests a doctor might suggest depending on what the suspected cause is. Urinalysis is the first-line investigation for urinary pain. This involves dipping a test strip (a dipstick) into a urine sample. If an STI is suspected, a doctor will refer the person to an STI clinic. A doctor may also want to get an ultrasound of the urinary tract if an obstruction is suspected.

If you would like to speak to a clinician online about urinary pain, you can through our video consultation service. It’s available from 9.30am to 4.30pm, five days a week.

Page last reviewed:  11/06/2020
Types of Treatment

Treatment for urinary pain depends on what the underlying cause of the pain is. Most of the time, an upper or lower urinary tract infection will be the cause, for which antibiotics can be prescribed.

What you can do to help urinary pain

There are some self help measures that can help relieve urinary pain, particularly from a urinary tract infection. Drinking lots of water can help to flush out an infection from the bladder, and refraining from having sex can stop the condition from getting worse (or being spread to someone else). Making sure you’re getting enough vitamin C can also have a positive effect by helping the immune system.

How is urinary pain treated?

If the pain is due to a urinary tract infection, antibiotics can be prescribed. Uncomplicated lower urinary tract infections may be treated with trimethoprim or nitrofurantoin. Symptoms should disappear within a few days.

For upper urinary tract infections caused by bacteria, the primary treatment option is also antibiotics. Azithromycin taken once as a single dose or a course of doxycycline are the first-line treatment options.

For vaginitis, there are various treatment options depending on the cause. Metronidazole tablets are the first line treatment for bacterial vaginosis. Anti-fungal cream and tablets can be taken for yeast infections. Metronidazole or tinidazole are two options for trichomoniasis.

Issues with the prostate that can cause urinary pain such as prostatitis can also be treated with antibiotics. An enlarged prostate may be treated in numerous ways. Alpha-blockers are typically used to relax the prostate gland, and lifestyle changes are made to help with the symptoms. These may include drinking less alcohol and caffeine, and bladder training. The herpes virus can also cause urinary pain, and may be treated with antiviral treatments such as aciclovir.

Urinary pain can be uncomfortable and if it is due to an infection, antibiotics will be needed to treat it. You can speak to one of our clinicians via our video consultation service. Appointments are available between 9.30am and 4.30pm, Monday to Friday. During your consultation, one of our GMC-registered clinicians can offer advice on managing the pain and let you know if you will need further investigation in person. Where appropriate, they can also issue prescriptions and referral to specialists for treatment. 

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have urinary pain for?

Although people may get mild urinary pain if they don’t drink enough clear fluids or if they smoke, it isn’t ‘normal’ to have it for a prolonged period of time. It can often be a sign of an infection, so you should see a doctor if pain is causing you noticeable discomfort or if it lasts for more than a day or two.

Is urinary pain serious?

In most cases no, but infections can escalate if they aren’t treated. 

Bladder infections may resolve by themselves over a few days, but antibiotics are usually required. In rare cases, a urinary tract infection may spread to other organs in the body such as the kidneys, and then into the bloodstream, which can be very serious.

Occasionally, urinary pain may also be indicative of an underlying problem requiring treatment, such as prostate disease. 

Can I get treatment for urinary pain?

Yes. Antibiotics are used to treat urinary tract infections and other bladder and kidney infections. They are available on prescription from your GP or from a registered clinician online.

Non-medicinal measures may also help, such as drinking a lot of water to flush out an infection.

How can I prevent urinary pain?

In order to avoid inflaming the urethra or vagina, it’s advisable to avoid possible irritants such as perfumed soap.

You can also limit your chances of getting an infection by going to the toilet regularly to relieve your bladder, and practising good genital hygiene and safe sex.

Can I speak to a doctor online about urinary pain?

If you are concerned about urinary pain, and you have not been diagnosed with an infection, you should speak to a doctor. Our GMC-registered clinicians are available for consultation between 9.30am and 4.30pm via our video consultation service, five days a week. They can offer advice about how to cope with the pain, prescribe treatment, and referral to specialists, where required.

Page last reviewed:  11/06/2020

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