Introduction
The burning sensation after urination, also called dysuria, can have various causes. Among the most common are the so-called uncomplicated cystitis or inflammation of the lower urinary tract. Other possible causes can be injuries, tumours and gender-specific causes.
Women are far more frequently affected by infections of the urinary tract than men, as the path from the bladder to the exit of the urethra is shorter than for men and pathogens can penetrate more easily. To find out the cause of the burning sensation, a urine examination is carried out and a urine culture is made. In some cases, imaging diagnostics such as ultrasound can help.
The therapy for most diseases consists of drinking a lot, regular emptying of the bladder and the application of heat in case of pain. The administration of antibiotics is not always necessary. An uncomplicated urinary tract infection usually heals within a week.
Causes
Uncomplicated cystitis is the most common cause of burning sensation when going to the toilet. Other typical symptoms of a urinary tract infection are frequent urge to urinate and pain in the lower abdomen. In children and older patients, however, the symptoms can also vary and then become noticeable through abdominal pain, urination at night, deterioration in general condition, fever or continence problems.
Urinary tract infections are usually caused by intestinal bacteria such as E. coli, enterococci, Proteus spp. and, more rarely, staphylococci, and are favoured by sexual intercourse, taking antibiotics, diabetes mellitus and anatomical or functional peculiarities. One speaks of a complicated urinary tract infection if the pathogens have penetrated through the ureter to the renal pelvis and caused an inflammation of the renal pelvis (pyelonephritis) there.
The inflammation of the renal pelvis is usually unilateral and the symptoms of the cystitis are then accompanied by fever, pain in the area of the renal bed, a severe feeling of illness and possibly blood in the urine. A disease that mainly affects women, which in addition to burning sensation also causes frequent urination and night-time urination and above all pain in the bladder area, is interstitial cystitis, also known as “painful bladder syndrome”. This chronic inflammatory disease is abacterial, i.e. not caused by bacteria, but the cause is still unknown.
Often affected patients also have another chronic disease like irritable bowel syndrome or fibromyalgia. The burning sensation after urination can also be caused by an inflammation of the urethra (urethritis), which is caused by bacteria, viruses or injuries caused by medical interventions. There are also gender-specific causes, such as inflammation of the woman’s uterus or vagina, and inflammation of the prostate gland in men.
Less common causes of burning sensation after urination can be bladder tumours, bilharziosis (a tropical infectious disease in which worms implant themselves in the urogenital tract), bladder stones or a narrowing of the bladder after injury (urethral stricture). If a man experiences a burning sensation after urination, this can be caused by inflammation of the glans (balinitis), the foreskin (which often accompanies balinitis, and is then called balanoposthitis) or the urinary tract and bladder. When the pain occurs during urination can be an indication of the cause of the pain.
If the pain is present immediately at the beginning of urination, the glans or urethra is usually affected. If the pain only occurs at the end of urination, there is a suspicion of cystitis. Inflammation of the glans occurs mainly in uncircumcised men, as poor intimate hygiene can irritate the sensitive glans.
However, too much intimate hygiene can also be bad for the glans, because soaps cause the acid protection of the mucous membrane to be lost or contact allergies to ointment ingredients or perfumes can occur. A latex allergy can also manifest itself in an inflammation of the glans and lead to a burning sensation after going to the toilet or even to a burning sensation in the glans. Other common causes of inflammation of the glans are infections with fungi, bacteria or viruses that can be sexually transmitted.
Inflammation of the glans can lead to pain after urination as well as to purulent secretions, redness, itching and swelling. The inflammation of the urethra (urethritis) can be caused by infection or injury. The infection of the urethra is divided into gonorrhoeic and non-gonorrhoeic.
This is based on whether the infection was caused by gonorrhoea (colloquially known as gonorrhea) or other pathogens (for example chlamydia). Injuries to the urethra are usually caused by medical interventions such as the insertion of a urinary catheter or examinations, less frequently by the introduction of foreign bodies by the patient. Cystitis in men is rare, but is usually caused by an enlarged prostate, anal sex, HIV infection or a bladder catheter.
If cystitis is the cause of pain after urination and is accompanied by fever, back pain and a general feeling of illness, the prostate is often also inflamed (prostatitis), which must be treated by a doctor. The most common cause of burning sensation after urination in women is cystitis (inflammation of the bladder). However, there are other possible causes, such as inflammation of the urethra or the female reproductive organs.
Typical symptoms of cystitis are burning and pain after urination, frequent urge to urinate and abdominal discomfort. In most cases the cystitis is caused by bacteria. Women can suffer from so-called “honeymoon” cystitis in sexually particularly active phases, where frequent sexual intercourse leads to a change in the vaginal environment and thus to a slight nesting of pathogens.
To prevent this, it is recommended to urinate directly after sexual intercourse. However, frequent sexual intercourse can also lead to irritation of the female genitals, which manifests itself as burning sensation after using the toilet. Due to a deficiency of the female sex hormone oestrogen, menopausal women can suffer from inflammation of the labia and vagina (vulvovaginitis), which can cause discomfort after urination or during sexual intercourse.
Increased colonisation of the vagina by the bacterium Gardnarella vaginalis leads to so-called bacterial vaginosis, which in most cases goes unnoticed and causes no discomfort, but sometimes can lead to inflammation of the vagina (colitis or vaginitis) and putrid, fishy discharge. Other pathogens that cause colpitis can be Candida albicans (a yeast fungus), Trichomonas vaginalis or herpes viruses. Here, too, there is discharge, itching, burning of the vagina and pain when urinating.
If this colpitis remains unnoticed for a long period of time, the infection can ascend to the kidneys or lead to infertility. Inflammation of the urethra (urethritis), which is caused by bacteria (chlamydia, gonococcus, etc.) or viruses (herpes viruses), can also be a cause of the burning sensation, although the onset here is rather gradual. Often there is an inflammation of the cervix at the same time.
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