Evaluation of dysuria

Diseases

Summary

Dysuria refers to discomfort, burning, or sensation of pain during micturition. Patients may also complain of urethral discomfort not associated with micturition. Dysuria may be external (i.e., urine irritating the inflamed genital organs) or internal (i.e., pain felt in the urethra).

Although urinary tract infection is the most common cause, any infectious or inflammatory condition affecting the genitourinary system may cause dysuria.

Epidemiology

Dysuria is a common presentation in primary care. It is generally more common in women, with a reported prevalence in women of up to 25% in the US per year and 27% in the UK per year.[1] [2] Approximately 1 million urinary tract infections are treated every year in US emergency departments, with a female:male ratio of 6:1.[3]

Although dysuria is uncommon in men, incidence increases with advancing age.[4] Lower urinary tract symptoms increase dramatically in men ages >40 years due to bladder outlet obstruction secondary to benign prostatic hyperplasia.[5] Among men of all ages who seek medical advice for urologic symptoms, dysuria is present in about 5% of cases.[6]

Library

CT scan showing left ureteric calculi
CT scan showing left renal stone (white arrow) with perinephric stranding around the left kidney (blue chevrons) and pyelonephritis
CT scan showing transitional cell carcinoma of the bladder blocking the right ureteric orifice
Emphysematous cystitis: (A) horizontal CT slice showing increased emphysema, (B) coronal CT slice showing increased emphysema, (C) sagittal CT slice showing increased emphysema

Citations

Key Articles

European Association of Urology. Guidelines on urological infections. Apr 2024 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: acute pyelonephritis. 2022 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: recurrent lower urinary tract infections in females. 2020 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: lower urinary tract symptoms-suspicion of benign prostatic hyperplasia. 2019 [internet publication].[Full Text]

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