Dysuria

Definition

Pain on micturition/urination/WEEING.

Epidemiology

Differential Diagnosis

• Urinary Tract Infection - this is the biggie. If you've got somebody with dysuria, it's probably (especially in a woman) a UTI. Girls get them all the time.
• Bladder issues - stones or a tumour
• STI - not really a lot else to say about this one.
• Prostate - prostatitis, benign prostatic hyperplasia, prostate cancer

Clinical and Associated Features

• UTI - dysuria, fever (possibly rigors), abdo pain, haematuria, frequency of urine
• Prostate
  • Cancer - dysuria, hesitancy/retention, haematuria, haematospermia (blood in sperm), pain (back, perineal, testicular), constipation. Secondary signs: bone - pain, fracture, hypercalcaemia, lower limb neurological deficit; jaundice; seizures; oedema. General features: weight loss, anorexia, fever.
  • Prostatitis - perineal pain, frequency, urgency, haematuria, pain on defaecation. Can progress to chronic prostatitis if treated poorly.
  • Benign prostatic hyperplasia - see prostatitis plus flattened surface on DRE.
• STI - very much depends on the STI but discharge, pain and infertility are all common symptoms.
• Bladder
  • Cancer - painless haematuria but often leads to UTIs if undetected, abdominal mass. General features: weight loss, anorexia, fever.
  • Stone - abdominal pain (radiating to tip of penis or labium majora), frequency, urgency, strangury (painful urgency and frequency after emptying bladder), end-micturtion haematuria, prostate enlargement (men), palpable mass on vaginal exam (women).