Pain or burning when urinating (alguria) is one of the most common reasons why people of both sexes visit their doctor. This is not surprising, as this discomfort is very unpleasant and often almost unbearable after a while. While women are usually diagnosed with “cystitis”, this is less common in men. In both male and female patients, there are a number of other possible causes, which we will inform you about in this article.

Please note: Informative articles such as this one are not a basis for self-medication and do not replace a visit to the doctor. If you have pain when urinating that has not subsided after two to three days, you should definitely consult your gynecologist or urologist to find out the cause and treatment options for your symptoms.
 

Causes of a burning sensation when urinating

As already mentioned at the beginning, there may be differences in the cause of these complaints when it comes to the gender of the person suffering from them. We have therefore separated the causes by gender for a better overview

 

Pain when urinating in women 

Bladder inflammation

The most common cause of burning when urinating in women is a urinary tract infection such as cystitis. Every second woman gets such an infection at least once in her life, but it can usually be treated well (uncomplicated urinary tract infection).
 
Cystitis is usually caused by coliform bacteria that enter the urethra from the bowel, for example during sexual intercourse or when wiping in the wrong direction (from back to front) after a bowel movement. As the urethra is much shorter in women than in men, the path for the germs is correspondingly short, which is why women suffer from cystitis much more frequently than men. 

Other symptoms of cystitis include a very frequent urge to urinate (dysuria), although only a few drops of urine are passed, which is usually cloudy and smells unpleasant. Seeing a healthcare professional and receiving the right treatment, if necessary with antibiotics, will in most cases quickly alleviate the symptoms and bring about a cure. If cystitis is not treated, the inflammation and pain can migrate to the kidneys and cause pyelonephritis.

Vaginitis

Colpitis or vaginitis is an infectious inflammation of the vagina. In addition to germs, irritation of the vaginal area or allergies can also be causes of such inflammation. Symptoms include burning when urinating, itching, vaginal discharge and redness of the skin in this area. Vaginitis is treated with antibiotics. Depending on the type of illness, treatment of the partner may also be necessary.

Vaginal dryness

This cause of burning when urinating is hormonal and mainly affects women during the menopause or while breastfeeding - due to the lower oestrogen levels, the mucous membranes are not properly moisturized, and irritation and minor injuries can occur due to rubbing, tight underwear or even when cycling. When urinating, the urine causes a burning sensation when it comes into contact with the irritated areas. The contraceptive pill and excessive intimate hygiene can also cause vaginal dryness.

Uterine prolapse

In the case of pelvic floor weakness, which can lead to uterine prolapse with displacement of the bladder, a burning sensation when urinating is also a symptom, combined with urinary flow disorders and frequent infections. Pelvic floor training, a pessary or, in severe cases, surgery are the treatment options here. 

 

Burning sensation when urinating in men

Problems with the prostate

If men have pain when urinating, this is more likely to be an indication of inflammation of organs other than the bladder. The most common cause of this symptom is an infection of the prostate. Also known as the “prostate gland”, the prostate surrounds the upper part of the urethra. For most of their lives, men do not notice this gland, but with age it can become enlarged or inflamed, which can lead to a burning sensation when urinating. Other symptoms that may indicate an enlarged prostate include pain in the perineal and anal area, fever, joint and muscle pain, frequent urination but little urine, a feeling of pressure in the lower abdomen and/or pain during ejaculation. If there is also a warm to hot feeling in the abdomen, this is an indication of prostatitis. 

As in women, prostatitis can be caused by germs from the intestines, but also by pathogens from sexually transmitted diseases such as chlamydia or gonorrhea. 

If the burning sensation when urinating occurs without any other symptoms, a tumor may be the cause. In any case, the symptoms should always be examined by a doctor as soon as possible.
 

Bladder infection

This type of urinary tract infection is very rare in men, as their urethra is much longer than in women and germs therefore do not reach the bladder as quickly. Conversely, this also means that bladder infections in men are more difficult to treat. Accompanying symptoms in men include slight incontinence and severe, cramp-like pain in the abdomen. Treatment with antibiotics is usually essential for this condition. If cystitis is not treated, the pathogens can spread to the epididymis and also lead to inflammation there, which must be treated with antibiotics.

 

Pain when urinating: cross-gender causes

In addition to the gender-specific causes of burning during urination, there are also causes that apply to both sexes.
 

Injuries

Superficial injuries in the genital area such as scratches or abrasions can occur during sexual intercourse, but also when wearing tight clothing or cycling. If these irritated areas come into contact with acidic urine, they can of course sting. However, these symptoms usually disappear after a few days when the injuries have healed.

Sexually transmitted diseases 

Some sexually transmitted diseases can cause a burning sensation when urinating. They are accompanied by other symptoms that vary depending on the disease:

• Gonorrhea: thick, yellowish discharge from the genitals or anus, abdominal pain
• Chlamydia: yellowish, sticky discharge, redness and itching in the genital area
• Trichomonads (unicellular flagellates): In men, this very common disease causes almost no symptoms. Women may experience pain during sexual intercourse, a foul-smelling discharge and severe itching in the genital area.

 

Bladder stones 

Bladder stones can form if the bladder is not completely emptied when urinating over a long period of time and the chemicals in the urine become imbalanced. In most cases, the stones are so small that they are excreted without any problems. Symptoms of bladder stones include a burning sensation, a frequent urge to urinate with little urine flow, cramps in the abdomen and a constantly interrupted flow of urine when urinating. 

Bladder cancer

A carcinoma in the bladder can also be responsible for the burning sensation when urinating. If all other diseases have been ruled out and the symptoms include blood in the urine, the doctor will examine the patient for bladder cancer. Men are particularly affected by this.

 

Pain when urinating: Diagnosis and therapy

So that your doctor can determine the cause of the pain when urinating and then treat it accordingly, it is also helpful to observe the pain and accompanying symptoms closely:
 

• Where does the pain occur? Already in the urethra or only when the urine comes into contact with the external genital organs?
• Is the pain recurrent or does it come on suddenly?
• Do you have a fever, discharge or itching?

The doctor treating you will ask you these questions and then first of all examine your urine. This test can detect an infection such as cystitis. If the test results are inconclusive, a visual examination is carried out and the affected organs are palpated. If kidney or bladder stones or prostate or bladder cancer are diagnosed, an ultrasound examination is also carried out. The treatment depends on the diagnosis: antibiotics are usually administered for infections, while treatment for more serious illnesses is individually tailored to the patient.

 

How you can prevent pain when urinating

Of course, it is not possible to prevent all diseases that cause a burning sensation when urinating. But you can reduce the risk of urinary tract infections and sexually transmitted diseases - here are a few tips.
 

Avoid urinary tract infections

The following tips (especially for women) can help to prevent urinary tract infections such as cystitis from developing in the first place:

• Drink enough. Drinking a lot flushes out your urinary tract - and ensures that germs and bacteria are simply flushed out.
• Dress warmly (including your feet). A chilled body is more susceptible to inflammation, so there is truth in the grandmother's saying “Don't sit on cold stones”. This also applies to wet clothing: After swimming, it is best to change out of your swimwear straight into dry ones. 
• Go to the toilet when you have a moderate urge to urinate and not when it becomes painful. 
• Empty your bladder completely: Residual urine provides an ideal breeding ground for germs.
• Wipe yourself from front to back so that no intestinal bacteria can enter the vagina and urethra.
• It is best to only use water or mild shower gel to wash your intimate area. Special products for intimate hygiene are not normally necessary.
• Wash yourself after sex, as intestinal bacteria can also get into your intimate area during sexual intercourse (honeymoon cystitis).
• Drink juices made from berries: The ingredients in cranberries, blueberries, sea buckthorn and cranberries include so-called tannins, which can strengthen the bladder mucous membranes. 

 

Preventing sexually transmitted diseases

The following applies to men and women: use condoms during sexual intercourse and pay attention to hygiene, including with sex toys, as gonorrhea & co. can also be transmitted via these.

 

Take advantage of preventive check-ups

The risk of diseases such as urinary bladder cancer (bladder cancer) or prostate cancer increases with age. In order to detect tumors as soon as possible and then be able to treat them, it is advisable to have regular check-ups.