Accompanying symptoms

The most common accompanying symptoms of pain when urinating are The various accompanying symptoms also provide clues as to the cause of the pain. The symptoms and their interrelationships are explained in more detail below.

Increased urge to urinate
Blood in urine
Fever and chills
Itching in the area of the urethra
Outflow
Back pain in the area of the flanks
Colicky pain
Conjunctivitis or joint inflammation

By far the most common cause of dysuria is the urinary tract infection commonly known as cystitis (urocystitis or simply cystitis).

It is caused by the immigration of bacteria into the urethra and bladder. The most common pathogen of uncomplicated cystitis is Escherichia coli (E. coli). In addition to the usually burning pain when urinating, a urinary tract infection is usually accompanied by a frequent urge to urinate with only small amounts of urine being discharged (pollakiuria).

In women, the inflammation can spread to the fallopian tubes and ovaries (pelvic inflammatory disease), which can lead to adhesions and in the worst case to infertility (sterility). Another very common cause of discomfort when urinating in men over 50 years of age is an enlargement of the prostate (benign prostatic hyperplasia = BPH). However, it is usually associated with an increased frequency of micturition (more frequent urination), a feeling of residual urine, a weakened urinary stream, night-time dribbling and a night-time urge to urinate (nocturia).

Pain only occurs when a urinary tract infection is added. Occasionally there is also a blood admixture to the urine (haematuria). This can be visible to the naked eye (macrohaematuria) or not visible but detectable with a urine strip test (microhaematuria).

On the one hand, this can indicate a urinary tract infection with damage to the tissue of the urethra or bladder. Furthermore, blood in the urine can also be found in tumors. Even the stoppage of a flaky and/or strong-smelling urine must be urgently clarified medically, since injuries of the urinary bladder, the ureter or other organ defects can be the cause.An important complication of an untreated urinary tract infection is the spread of the inflammation to the kidney tissue, leading to the development of inflammation of the renal pelvis (pyelonephritis).

This is usually accompanied by a severe feeling of illness, fever and chills and requires urgent and prompt treatment. Complications of urethritis in men are an inflammation of the prostate gland (prostatitis), which is usually accompanied by a strong feeling of illness, fever and chills, and an inflammation of the epididymis. Acute appendicitis (appendicitis) can also cause pain when urinating in combination with fever.

In most cases, however, the symptoms begin with pain in the region of the navel, which then moves to the right lower abdomen. Inflammation of the large intestinal protrusions, sigmoid diverticulitis, can also cause pain when urinating. However, pain in the left lower abdomen is much more frequent.

Another cause of dysuria can be an isolated inflammation of the urethra without involvement of the bladder, this is called urethritis. A distinction is made between non-specific urethritis, which can be caused by numerous bacteria, and specific urethritis caused by gonococcus (Neisseria gonorrhoeae), which is better known as gonorrhea. In addition to the burning pain when urinating, patients with urethritis often complain of constant itching in the area of the urethra and discharge from the urethra (urethral fluorine).

It should not be forgotten that the sexual partner should also be examined and, if necessary, also treated. Otherwise, the inflammation may not heal even under antibiotic therapy of one partner, because a renewed infection by the untreated partner is possible. Further possible accompanying symptoms are back pain in the area of the flanks, which occurs mainly in the case of inflammation of the renal pelvis (pyelonephritis).

In this case, a doctor should be consulted, as an untreated inflammation of the renal pelvis can lead to the bacteria being washed out into the blood and thus to life-threatening urosepsis. Stones in the area of the bladder or urethra can also cause pain when urinating. Mostly, however, the stones are found somewhat higher in the area between the kidney and the bladder, in the ureter.

Here they lead to typical colicky pain and distinct discomfort. Colicky pain also occurs in inflammation of the renal pelvis. A special form of urethritis is the so-called Reiter syndrome, a complex of symptoms in which patients suffer from conjunctivitis and arthritis in addition to urethritis. It belongs to the autoimmune diseases. From time to time conjunctivitis also occurs in connection with chlamydial infections, when the infection is transmitted from the genital area to the eye or is transmitted to the child at birth.