Burning urine is common term to describe a burning sensation or burning pain during or after urination. The medical term is dysuria, and is an indication of inflammation of the lower urinary tract – urethra and bladder, with the prostate gland often involved in men. Burning during urination may also be seen when there is inflammation of other genitourinary organs, even though the urethra, bladder and prostate are not involved.
Usually it is not the change in chemical composition of urine that causes the burning sensation. The already inflamed lining of the urinary tract are further irritated by the passage of urine during urination. Contraction of the muscular linings of the lower urinary organs further contributes to the pain and discomfort. The burning sensation may continues after urination as the inflammation persists for minutes or even hours afterwards.
Signs and Symptoms Associated With Burning Urine
The presence of other signs and symptoms that often accompany may provide an indication of the cause. This includes :
- Blood in the urine (hematuria) – urine may appear dark yellow, brown, orange or red depending on the quantity of blood in the urine.
- Urgency to urinate
- Vesical tenesmus – sensation of incomplete emptying of the bladder after passing urine
- Urinary incontinence – involuntary expulsion of urine varying from a few drops to complete emptying of the bladder
- Frequent urination
- Post-micturition dribble – passage of small quantities of urine after urinating
- Difficulty urinating – straining, hesitancy
- Discharge – urethra and vagina (women)
- Urine abnormalities – cloudy urine, foamy urine, strong-smelling urine (sometimes offensive odor)
- Blood in the semen (hematospermia) in men
- Pelvic and lower abdominal pain
Causes of Burning Urine
The causes of burning urine can be broadly divided into infectious and non-infectious causes. There are a number of causes of burning urine but most cases are due to urinary tract infections. Urethritis affects both men and women, but as the infection progresses, it may inflame the bladder (men and women) and/or prostate gland (men).
Infectious Causes of Burning Urine
Most infectious cases of burning during or after urination are due to a bacterial infection. It is often an ascending infection meaning that the microorganisms gains entry via the external meatus, infects and inflames the urethra and the infection progresses up the urinary tract.
Less frequently, the infectious agent reaches the urethra or bladder from higher up the urinary tract (ureters or kidney), neighboring sites (like the rectum) or distant sites in the body. In the latter two cases, the spread is via the direct infiltration, blood stream or lymphatic system.
The common pathogens responsible are discussed under :
While bacteria are the most common causes, at times viruses, protozoa and even fungi may be the cause of the infection. Parasites like schistosomes (schistosomiasis) may also cause burning during and after urination but are more commonly seen in endemic areas.
An offensive smelling discharge or urine with an infection and swollen groin lymph nodes are usually indicative of an infection. Infection of surrounding structures in the pelvis/perineum may also cause burning during and after urination although the urinary tract itself is not involved.
- Urethritis (urethra)
- Inflammation of the urethra often related to sexually transmitted infections – gonorrhea, chlamydia, syphilis and genital herpes
- Offensive smelling discharge and itching of the external genitalia.
- Swelling of the penis, particularly the tip.
- Pain during intercourse (men, women) or ejaculation (men).
- Cystitis (bladder)
- Constant dull ache/pain in the pelvis/perineum, sometimes just below the umbilicus (belly button) when the bladder is full, and may radiate to the flanks or back.
- Frequent urination, urging and sometimes incontinence.
- Fever is more frequently seen with cystitis than urethritis.
- Prostatitis (prostate gland)
- Difficulty passing urine – hesitancy, straining and/or dribbling
- Urgency to urinate
- Frequent urination
Other infectious conditions that lead to burning urine :
- Vulvovaginitis (vulva and/or vagina in women)
- Cervicitis (cervix in women)
- Epididymo-orchitis (testes, epididymis in men)
Non-Infectious Causes of Burning Urine
- Post-operative (pelvic surgery)
- Urethral catheter
- Vigorous sexual activity
- Foreign body
- Chemical irritation and allergies
- Latex condoms
- Soap and bubble baths
- Toilet paper
- Tampons or sanitary pads
- Urethral stricture (narrow urethra)
- Urinary stones
- Atrophic urethritis (post-menopausal women)
- Bladder stones
- Interstitial cystitis
- Radiation cystitis
- Bladder cancer
- Cystocele (fallen bladder in women)
- Prostate Gland
- Benign prostatic hypertrophy (BPH)
- Prostate cancer
- Non-infectious prostatitis
- Gout medication
- Chemotherapeutic drugs
- Systemic, Autoimmune and Metabolic
- Reactive arthritis (Reiter’s syndrome)
- Behcet’s syndrome