Why can urination be painful?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
There are a number of reasons why urinating can become painful. A painful, burning sensation is a classic symptom of a urinary tract infection, or UTI. Passing urine is a complex process that involves a number of different organs, including:

• the kidneys, which process fluids and produce urine
• the ureters, or tubes that transfer urine from the kidneys to the bladder
• the bladder, which is the organ that stores urine
• the urethra, the tube that empties urine from the bladder

An infection in any of these organs could make urinating very unpleasant.

Women and girls can develop painful urination for a variety of other reasons. Yeast infections are one common cause. Irritation from exposure to chemicals in personal-care products can pose a problem, too. Among men, conditions such as prostatitis can make peeing an experience to dread.

If you have painful urination that lasts longer than one day, or that's accompanied by other symptoms such as discharge from the vagina or penis, see your doctor immediately.
Dr. Michael Roizen, MD
Internal Medicine
The main cause of painful urination typically is an infection in your lower urinary tract, called a UTI. As the urine streams through inflamed, infected tissue it burns and stings. The bladder and the urethra narrow and become as sensitive as a newborn baby to anything that passes through it. Infections can also cause the bladder to contract at will, making you a frequent throne room visitor. Painful urination can also come about from an upper UTI affecting the kidney or when the nerves supplying the kidney, bladder, or urethra are damaged from inflammation or disease.
Lisa J. Broyles, MD
Family Medicine

[media id="DEV__4c7508e6560bc2_26831248" title="Urinary Bladder"]

Urination can be painful for several reasons, including infection, obstruction, or chronic inflammation.  Both men and women can develop bacterial infections of the urine and or kidneys.  Men with an enlarged prostate are also more prone to bladder infections as the swollen prostate obstructs urine flow through the urethra.  Urinary tract infections occur when bacteria from outside the body enter the urethra and once inside the bladder multiply. Dehydration, drinking lots of caffeine and any pre existing factors such as pregnancy can make this more common.  You can decrease the chances of getting a bladder infection by taking over the counter cranberry tablets daily or drinking daily cranberry juice.  Also drink lots of water and less caffeine.  Women also need to urinate soon after sexual activity to decrease the incidence of post sexual activity bladder infections.  Other types of infections can cause painful urination in men such as prostate infections or sexually transmitted infections such as chlamydia.

Urinary obstruction from a kidney stone passing through the urethra can be very painful as well.  This pain can be very severe and is often accompanied by blood in the urine.  Men will note a decreased rate or urine flow and hesitancy with some lower abdominal pressure if the prostate is swollen.  The prostate surrounds the urethra and when this swells, most commonly a condition called benign prostatic hypertrophy, the urine stream becomes obstructed and or painful. 

Chronic inflammation can cause painful urination called cystitis, although this is much less common than infection or obstruction.  Most commonly seen in women and people who smoke cigarettes, cystitis is inflammation of the bladder lining.  Antibiotics do not help this condition and urine will be clear on examination in a doctor's office.

Picture of Enlarged Prostate