Formula Medical Group
Apple Valley, CA

James Krider, MD

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Urination problems - dysuria

The characteristics of the urine provide diagnostic clues about many different diseases. The urine's color, quantity, odor, and sediment, as well as difficulties in controlling its flow, can all be indicators of conditions originating both in the genitourinary system and elsewhere in the body.

An adult usually urinates about 6 times each day, excreting a total of about a quart and a half of urine. Normal urine is straw colored and has a sharp but not unpleasant odor. Painful Urination, or dysuria, is a distressing symptom that should always be investigated by a doctor.

Causes of urination problems

Bladder cancer
Blood in the urine is usually the first warning signal of bladder cancer. The blood often appears suddenly, and pain may or may not be present. In some cases, however, the bleeding leads to discomfort because blood clots form and cause painful muscle spasms in the bladder.

Bladder stones
A stone that has formed in the bladder or passed from the kidney to the bladder causes pain as well as a frequent urge to urinate. Blood, pus, and albumin (a protein) may also be present in the urine. The muscle contractions of the bladder and urethra may push small stones out of the body within several hours, but larger ones are often extremely painful and require immediate surgical removal.

This bladder infection, which affects women more often than men, may be acute or chronic. Pain in the pubic area and painful, burning sensations when urinating are common symptoms, along with frequent urination and an urge to urinate when the bladder appears to be empty. In the chronic form, the urine may also be cloudy, bloody, or foul smelling.

Enlarged prostate gland
This condition affects many men over the age of 40 but usually becomes a problem around age 60. Pain and discomfort develop in the area of the prostate, which is just below the bladder and close to the rectum. Urination, which is frequent and urgent (particularly at night), causes burning pain. The urine stream tends to be weak and slow to start, and it is difficult to empty the bladder completely.

Job-related fatigue is often due to stress or boredom

Prostate cancer
Prostate cancer, which causes symptoms similar to those of an enlarged prostate, is common among elderly men. Urination produces a painful or burning sensation, and there is an increased urge to urinate. There may be difficulty starting to urinate or holding back urine, or it may be impossible to expel any urine at all.

Prostatitis, an inflammation of the prostate gland, is most common in men under age 35. It is caused by infection either with a sexually transmitted organism (such as the one that causes gonorrhea) or with bacteria carried by the blood from a distant site such as the tonsils or sinuses. The onset is often sudden, with sharp pain radiating from the area between the scrotum and anus into the testicles. Urination is difficult and painful, and there may be blood at the beginning or end of the stream.

Urinary obstructions
Painful urination and reduced flow are signs that the urinary tract is obstructed. Such obstruction may be the result of an infection, a swollen prostate, or a urinary stone. Urinary obstruction may also cause lower abdominal pain, and the urinary flow may be hesitant, with dripping or dribbling.

Wilms' tumor
This is the most common type of kidney cancer in children, usually occurring from infancy to age 15. It is rare in adults. The most common sign is a lump or swelling in the abdomen. About one-fourth of all patients have blood in the urine, which may be accompanied by painful urination. Other signs and symptoms include low-grade fever, fatigue, loss of appetite and weight, and anemia.

Advice about urination problems

  • Painful urination is always a significant symptom, whether or not it is accompanied by blood. Report the problem to your doctor as soon as possible.
  • If you have cystitis, drink plenty of fluids in addition to taking medication the doctor prescribes. Cranberry juice helps create a bladder environment hostile to bacteria.
  • Men over 40 should have a yearly rectal examination to detect early prostate cancer.
  • Don't smoke. Cigarette smokers have a three-fold increase in bladder cancer.
This article was last reviewed November 15, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Bladder stones
Cancer, bladder
Cancer, prostate
Enlarged prostate
Urinary obstruction
Wilms' tumor

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