Therapy

Pain during urination must be treated urgently, depending on the underlying cause, since further complications can arise if appropriate therapy is not provided. Bacterially triggered inflammatory processes in the area of the bladder, urethra or renal pelvis are usually treated with a suitable antibiotic. In order to be able to select the most effective antibiotic, it is essential to determine the exact germ count.

In most cases, preparations such as amoxicillin or cotrimoxazole are prescribed. The treatment usually lasts for a period of 5 – 7 days and should definitely be continued until the end. If the patient stops taking the antibiotic on his own, the symptoms may worsen again and the bacterial pathogens may develop resistance.

In case of abnormalities or intolerances, the treating physician should be consulted again for this reason. In order to relieve the pain when urinating as quickly as possible, it is recommended that the treatment be supported by increased drinking habits. Water and/or unsugared tea is particularly suitable.

In this way, the bacterial pathogens are flushed out of the urinary tract more quickly and a rapid improvement in symptoms is achieved. In the case of causes such as bladder or urethra stones, an endoscopy (mirroring) must often be performed. In the course of this procedure, the bladder and urethra can be examined without extensive surgery and small stones can be removed.

Larger stones must be shattered before removal.For this purpose a special ultrasound probe is inserted. An operation is only necessary in special cases. In the presence of a sexually transmitted disease that causes pain when urinating, a specific treatment must be performed. Painkillers can be taken to directly relieve the pain during urination.

Pain during urination in women

The most common cause of pain when urinating in women is cystitis. The type of pain is very characteristic: a burning sensation that gets stronger and stronger towards the end of the visit to the toilet and moves into the abdomen, combined with a persistent urge to urinate, which does not go away even after that. The cystitis is a common disease in women, due to the short urethra of only about 3 cm length, and the proximity to the rectum with all the bacteria.

It can often be treated without antibiotics by drinking plenty of fluids of about 3 liters/day and using herbal remedies such as bladder tea, cranberry juice or Angocin from the pharmacy. Warmth likewise relieves the symptoms. If the pain has not gone away after a few days, a presentation to the doctor is necessary.

There a urine sample is then handed in and examined for signs of inflammation and the presence of bacteria. In case of recurring cystitis, it is recommended to go to the toilet as a preventive measure no later than 15 minutes after sexual intercourse. This will flush out any bacteria that may have been introduced directly before they can settle in the bladder.

If the pain is less typical for a cystitis but only burns superficially, other diseases are also possible. If there is inflammation or injury to the labia and genital area, the urine may be irritating and burn. This is typical, for example, of fungal infections of the genitals with Candida albicans.

The burning and itching is permanent, but it gets worse when it comes into contact with urine. Infections with the herpes virus or other sexually transmitted diseases can also cause a burning sensation when urinating. The decisive factor is therefore the pain characteristic in order to distinguish between a conventional cystitis and another infection that burns on contact with urine.

Pain when urinating is also possible during pregnancy. From the second to third trimenon onwards, the child is large enough that the bladder may also be affected. Due to the shortage of space in the abdomen, the pregnant woman feels a frequent urge to urinate.

However, it can happen that the baby lies down completely on the bladder and squeezes it. The mother notices this through stabbing pain. The stretching of the ligaments that hold the uterus in the abdominal cavity during pregnancy can also be painful when urinating, as the muscles of the pelvic floor work.

However, cystitis must always be taken into consideration during pregnancy as well. Pregnant women are automatically considered to have a complicated cystitis, because in this case the ascent of the infection into the renal pelvis through dilated ureters is easier. In any case, a urine culture should be made and treated with an antibiotic, e.g. Nitrofurantoin or Fosfomycin, despite pregnancy.

However, antibiotics from the quinolone class must not be used. Urethritis during pregnancy may pose a risk to the child depending on the pathogen. An untreated colonization of the urethra with chlamydia or gonococcus during birth can lead to conjunctivitis in the child.

Antibiotics during pregnancy and pain when urinating during pregnancyPain when urinating is not a sign of pregnancy. If you suspect that you are pregnant and experience pain while urinating, this is most likely due to cystitis or infection with a sexually transmitted disease. Unprotected sexual intercourse is of course the basis of both pregnancy and the acquisition of such an infection.

If the pain is persistent and also occurs during urination, when a positive pregnancy test may already be available, the rare case of an extra-uterine pregnancy must also be considered. This means that the embryo has not nested in the uterus as intended, but elsewhere, e.g. in the fallopian tubes, the ovary or even in the abdominal cavity.This causes severe pain and in rare cases can mimic the symptoms of a urinary tract infection. In this case, however, the pain is permanent and more or less independent of urination.

This is an emergency and should be presented to a doctor immediately. Painful urination after the birth of a child is a relatively common phenomenon. At birth, a lot of raw force and pressure is applied to the ureter and bladder.

The tissue is squeezed and as a natural process, after this type of injury, it stores water. This process is called edema formation, and these edemas can constrict the urethra. This makes it more difficult to discharge urine, which can cause urine to collect in the bladder and make it painfully full.

In the case of such disturbances of urination after birth, an additional bladder infection must also always be excluded. This is always a possibility, even after birth. Aggravating is the fact that the female body is sensitive after the feat of childbirth and the abdomen already hurts anyway. Often it is also no longer possible to distinguish between bladder pain during urine congestion and physical pain after birth, which is why special attention must be paid to urination. Such phenomena are often observed after births with epidural (epidural anaesthesia) or surgical-vaginal births.