Painful Urination

Why does it sometimes hurt when I urinate?
A painful burning feeling when you urinate is often a sign of a urinary tract infection (sometimes also called a bladder infection). However, painful urination can occur even if you don't have an infection. Certain drugs, like some used in cancer chemotherapy, may inflame the bladder.
Something pressing against the bladder (like an ovarian cyst) or a kidney stone stuck near the entrance to the bladder can also cause painful urination.
Painful urination can also be caused by vaginal infection or irritation. You might be sensitive to chemicals in products such as douches, vaginal lubricants, soaps, scented toilet paper or contraceptive foams or sponges. If it hurts to urinate after you've used these products, you're probably sensitive to them.

What will I need to tell my doctor?
You should tell your doctor about your symptoms and how long you've had them. You should also tell your doctor if you've had urinary tract infections before (including when you were a child), how many you've had and how they were treated. Tell your doctor about any medical conditions you have, such as diabetes mellitus or AIDS, because these could affect your body's response to infection. Tell your doctor about any known abnormality in your urinary tract, or if you are or might be pregnant. Tell your doctor if you've had any procedures or surgeries on your urinary tract or if you were recently hospitalized (less than 1 month ago) or stayed in a nursing home.

What type of tests will I need to have?
Your doctor will usually be able to tell what's causing your pain by your description of your symptoms, along with a physical exam. Testing your urine (urinalysis) can also help your doctor identify what type of infection you have. Usually, a sample of your urine is taken in your doctor's office and sent to a lab to check for infection.
If your doctor thinks your pain may be from vaginal inflammation, he or she may wipe the lining of your vagina with a swab to collect mucus. The mucus will be looked at under a microscope to see if it has yeast or other organisms. If your pain is from an infection in your urethra (the tube that carries urine from the bladder), your doctor may swab it to test for bacteria. If an infection can't be found, your doctor may suggest other tests.

How are urinary tract infections treated?
If you are a healthy adult man or woman (who is not pregnant), a few days of antibiotic pills will usually cure your urinary tract infection. It's important that you tell your doctor if you have symptoms such as back pain and fever (especially a fever over 38°C, which could mean that the infection has spread to your kidneys). It's also important that you take the antibiotic exactly as your doctor has said, since skipping pills could make the treatment less effective and may allow a kidney infection to develop.

What can I do if I keep getting urinary tract infections?
Some women get these infections over and over again, and they may get some relief from preventive efforts. There are changes you can make in your habits that can help. For example, drink plenty of fluids, especially water.
Drinking cranberry juice may also help prevent urinary tract infections. However, if you're taking warfarin, check with your doctor before using cranberry juice to prevent urinary tract infections. Your doctor may need to adjust your warfarin dose or you may need to have more frequent blood tests. If you tend to get urinary tract infections after sexual intercourse, going
to the bathroom right after intercourse may lessen your risk.
Frequent urinary tract infections may be caused by changes in the bacteria in the vagina. Antibacterial vaginal douches, spermicides and certain oral antibiotics may cause changes in vaginal bacteria. Avoid using these items, if possible. Menopause can also cause changes in vaginal bacteria that increase your risk for urinary tract infection. Taking estrogen usually corrects this problem, but may not be for everyone.
If you are having 3 or more urinary tract infections each year, your doctor may want you to begin a preventive antibiotic program. A small dose of an antibiotic taken every day helps to reduce the number of infections. If sexual intercourse seems to cause infections for you, your doctor many suggest taking the antibiotic after intercourse.
(AAFP)