Dysuria is the term used to indicate both the manifestation and the sensation of difficulty in urinating , that is, problems during urination .
It is a very common disorder that can affect each of us and that can manifest itself several times in the course of life, especially if you are predisposed subjects as we will deepen in the course of the article.
It goes without saying that this information suggests that in most cases, dysuria is a symptom resulting from minor disturbances and resolves them in a short time without leaving traces of permanent lesions.
As we will see later the causesthey are many and of different nature. In most cases they are due to simple inflammation of the urinary tract, but sometimes the cause can have a much more relevant clinical significance, and which requires specific and rapid investigations.
Often dysuria is accompanied by other symptoms such as pollakiuria and stranguria which we have talked about in other in-depth guides that you can read on the blog.
Let’s get straight to the heart of our discussion by trying to explain to you what are the symptoms and manifestations associated with dysuria .
What symptoms are felt in case of dysuria
In most cases the symptom felt is a sensation of pain and burning that accompany or precede the emission of urine, but this is a general rule and not always valid.
At this point, however, it is useful to differentiate different types of urination disorders and different urine alterations, which can often be confused.
Below is an exhaustive list of the manifestations associated with dysuria which will be useful later when the main causes of this disorder are illustrated:
- Stranguria : a condition that indicates the presence of pain when passing urine or in the phases that precede it. Often the painful sensation is also felt in case of dysuria ;
- Pollakiuria : this term refers to the need to urinate much more often than normal, but without increasing the volume of urine. This is because the subject’s bladder loses its collection capacity or because a discrepancy is created between the information that reaches the brain and the actual amount of urine present in the bladder. The brain receives incorrect signals, therefore it will emit signals to urinate even if the bladder is empty;
- Anuria : condition in which the production of urine is lacking, often the consequence of a strong state of dehydration or absent renal perfusion. This is a medical emergency that must be treated promptly;
- Nocturia : term that indicates the increase in urine production at night;
- Hematuria : indicates the loss of blood in the urine and is often associated with clinical pictures of particular interest and which require timely investigations;
- Chyluria : rare situation in which there is the presence of lymph and kilo in the urine that appear opaque and milky.
To these are added conditions such as waiting and hesitation in the act of urinating, a characteristic symptom of patients suffering from prostatic hypertrophy.
At this point, having illustrated the main differences between a condition of dysuria from the other main disorders of urination, let’s move on to deepen the main causes that determine dysuria, namely the difficulty in urinating.
What are the causes of dysuria ?
Infections are undoubtedly the most frequent causes of dysuria . These are generally bacterial in nature but can also be viral or fungal, in any case the infection leads to a state of inflammation and therefore edema, and consequent painful or burning sensation.
Let’s see at this point the most common forms of urinary tract infection:
Cystitis
It is a condition characteristic of the female sex (in the male it is called prostatitis). It can occur in episodic, recurrent or chronic form and is due to a bacterial infection of the bladder. Symptoms complained of are dysuria , burning when urinating and pollakiuria .
Urethritis
This is inflammation of the urethra most often caused by sexually transmitted bacterial infections such as gonorrhea and chlamydia . Symptoms felt are dysuriaand the possible presence of purulent and foul-smelling secretions coming from the urethra. It is an infection that affects the male gender much more frequently than the female gender, this in relation to the anatomical differences.
Pyelonephritis
Unlike the previous two infections affecting the lower urinary tract, pyelonephritis is an infection affecting the upper urinary tract, i.e. the kidney and renal pelvis. But despite this, there are also repercussions on the lower urinary tract, in fact it is very common that episodes of cystitis and therefore dysuria arise from this condition .
In addition to causes attributable to different types and localizations of bacterial infections, there are other situations that can lead to the presence of this disorder. Let’s analyze them in detail.
Kidney
stones Stones are crystallized formations that are created in relation to several factors: high- protein diet and kidney diseases that obstruct the urinary tract during their transit towards the bladder, causing pain and increased pressure in the urinary tract. Once in the bladder the stones will be expelled, causing pain and difficulty in urinating .
Prostatic hypertrophy
It is a pathology of strong clinical interest that affects men over 50 years of age. It is a slowly evolving neoplastic process that leads to an increase in the volume of the prostate gland. The prostate gland is located below the bladder and its increase in size and stiffening presses on the bladder, generating the sensation of having to urinate frequently. A typical sign of prostatic hypertrophy and then the hesitation that is created at the time of urination.
Prostatitis
It represents the male equivalent of cystitis and is the infection of the prostate by rather common bacteria such as Escherichia coli . Symptoms felt in addition to dysuriathey include fever, chills, nausea, and vomiting.
Cancer of the urinary tract
It can affect the urinary tract in all its locations, but generally to cause major disorders related to dysuria and cancer localized to the bladder. Among its manifestations there is also cystitis, therefore the urge urination.
How the diagnosis is made
We have seen how the causes of dysuria can be very different and require a specific intervention by the doctor to resolve the problem.
However, only a correct diagnosis allows us to be able to put the therapy into practicefair and effective. We therefore understand the strict need to consult a doctor quickly if the problem persists and to undergo all the tests indicated, without delaying or underestimating one’s condition.
In general, the diagnostic process includes all those typical investigations that are summarized in the anamnesis, in the physical examination and in the most appropriate specialist examinations.
During the medical history phase, the doctor collects information relating to the perceived symptoms and the general state of health of the patient. Questions are then asked that investigate the type of disturbance felt, whether this is continuous or episodic, whether other symptoms are associated and whether the disturbances occur in conjunction with particular conditions.
During the visit, the doctor can then palpate the subject’s abdomen to look for any signs such as masses, swellings or skin manifestations. A blood and urine
sample is then collected which will be useful for verifying the presence of infections and identifying the pathogen. In particular, if a bacterial infection is suspected, it is considered appropriate to carry out a urine culture and subsequent antibiogram to identify and isolate the bacterium.
To investigate, however, the presence of tumor masses or simple stones, an ultrasound is very useful in order to observe in detail the surface of the organs and their internal structure. What are the most effective therapies
The therapies are prescribed by the doctor based on the pathological condition that triggered the symptom of dysuria .
If at the base of this disorder there is an infection, a targeted drug therapy is administered which may consist in the assumption of specific antibiotic or antifungal drugs against the pathogen responsible for the infection.
To these drugs, always and only on the advice of the doctor, anti-inflammatories can also be added to reduce pain if it occurs in an acute and difficult to bear form.
In case of kidney or bladder stones, depending on the severity and consistency of the crystals, painkillers and antispasmodics are administered to relieve severe pain and anti-inflammatories, but it may be necessary to resort to surgery if the kidney stones are very large.
As regards, however, the states of prostatic hypertrophy or cancer , the therapy will be evaluated on the individual case, taking into account the age and general state of health of the patient and will be dealt with by a specialist doctor.
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