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Evaluation of dysuria in adults
Judy D Bremnor1, Richard Sadovsky
1State University of New York Health Science Center at Brooklyn College of Medicine, 11203, USA.
American Family Physician
|May 7, 2002
Summary
Dysuria, or painful urination, is common, especially in women. While urinary tract infections are frequent causes, other factors like inflammation or trauma can also cause pain during urination.
Area of Science:
- Urology
- Infectious Diseases
Background:
- Dysuria (painful urination) is more prevalent in women than men.
- Urinary tract infections (UTIs) are the most common cause, but not always treatable with antibiotics.
- Demographic factors like age and sexual activity influence dysuria incidence.
Purpose of the Study:
- To outline the differential diagnosis of dysuria.
- To emphasize the importance of a thorough patient history and physical examination.
- To guide appropriate diagnostic testing for dysuria.
Main Methods:
- Comprehensive history and physical examination.
- Urinalysis for infection detection.
- Urine cultures, urethral, and vaginal smears/cultures for pathogen identification.
Main Results:
- Escherichia coli is a common UTI pathogen causing dysuria.
- Noninfectious causes include inflammation, trauma, neoplasms, and interstitial cystitis.
- Imaging is rarely needed but useful for complex upper urinary tract issues.
Conclusions:
- Dysuria diagnosis requires careful evaluation beyond just UTIs.
- Diagnostic strategies should be tailored to patient history and symptoms.
- Prompt and accurate diagnosis prevents unnecessary antibiotic use and guides treatment.