Cramps during urination in men are noted with urethritis, foreign bodies, polyps and tumors of the urethra, cystitis, urolithiasis. The cause can be andrological pathologies: balanoposthitis, epididymitis, diseases of the prostate gland. The symptom is often combined with other dysuric disorders. The cause is established on the basis of the clinical picture, hardware and laboratory data. As part of conservative therapy, antimicrobial agents, NSAIDs, analgesics, local procedures, and physiotherapy are used. Operations are carried out according to indications.
Why do men get cramps when urinating
Nonspecific urethritis
The urethra in men is much longer than in women. This creates predisposing conditions for the development of infection and causes a higher incidence of urethritis in the stronger sex. The cause of primary nonspecific inflammation is the development of conditionally pathogenic microflora after medical manipulations and casual sexual relationships.
Acute urethritis is manifested by pain during urination, the appearance of pathological secretions of a purulent or mucopurulent nature, and a slight swelling of the meatus. With the transition to the chronic form, the symptoms are smoothed out. Secondary urethritis is formed when the infection penetrates from neighboring foci (seminal vesicles, prostate). Symptoms are less pronounced than with primary inflammation, the discharge is poor.
STI
In most cases, when infected with an STI, men develop specific urethritis. Details of the clinical picture vary depending on the type of pathogen:
- Gonorrhea. The disease manifests suddenly 5-1 days after infection. Cutting, burning and pain are complemented by the appearance of copious creamy grayish-yellow discharge. With damage to the anterior urethra, the general condition does not suffer. When spreading to the back of the urethra, marked hyperthermia, intoxication, and increased pain are noted.
- Trichomoniasis. Often asymptomatic. Clinically significant forms debut 5-15 days after infection. Itching and burning, usually minor, occur after sexual intercourse and urination. The discharge is mucopurulent. Almost half of men develop prostatitis. Possibly epididymitis.
- Chlamydia. Typically sluggish oligosymptomatic course. Unpleasant sensations are not intense, they are noted during micturition. The external opening of the urethra is red and swollen. Manifestations gradually decrease. Allocations are detected only in the morning hours. Chlamydial urethritis in some cases is complicated by Reiter's syndrome with lesions of the conjunctiva and joints.
- Ureaplasmosis. The duration of the incubation period reaches 3 or more weeks. Clinical manifestations include discomfort during urination. Rezi can be both moderate and sharp, painful. Sexual intercourse becomes painful. General hyperthermia, chills, pain above the pubis, sexual disorders, transparent meager discharge are determined.
- Mycoplasmosis. Symptoms, on average, occur after a month, sometimes after 2 months. Weakness and moderate hyperthermia are combined with itching of the head, discomfort, burning. Allocations are translucent, not abundant. Pulling pains in the groin, decreased libido, acute pain during sexual intercourse are found.
Candidiasis in men develops during sexual intercourse with women suffering from a fungal infection of the vagina. More often occurs in the form of balanitis or balanoposthitis, not accompanied by urination disorders. Candidiasis urethritis is less commonly observed, which is manifested by minor pains, slight burning and itching. Allocations are muco-watery, scanty, rarely purulent, abundant.
Traumatic injuries of the urethra occur in traffic accidents, industrial accidents, disputes, criminal incidents, medical manipulations. Urethral injury without complete rupture is characterized by cramps, soreness and difficulty urinating, blood in the urine, swelling of the penis in the area of injury, hematomas of the scrotum and perineum.
Foreign bodies most often enter the urethra as a result of sexual experiments. Rough edges and large objects cause ischuria and gross hematuria. Subsequently, soreness and cramps appear, aggravated during urination. If fragments of instruments are accidentally left after medical manipulations, the manifestations are less pronounced, the posterior urethra suffers more often.
Cramps when urinating in men
The clinical picture is determined by the nature of the mass formation in the urethra:
- Polyps. They are more common in men over 45 years of age. Initially, there is a slight burning sensation during micturition. Subsequently, dysuria, difficulty urinating, join. Possible incontinence provoked by laughter, sneezing, coughing. With damage to the submucosal layer, hematuria is observed.
- benign tumors. There is considerable variability in symptoms. They are asymptomatic for a long time. With growth, they provoke itching and burning in the urethra, discomfort during urination. Bleeding, deviation, bifurcation or splashing of the jet, imperative urges, partial incontinence, urinary retention may be detected. Resi, as a rule, join with the development of urethritis, are supplemented by an increase in miction, suppuration.
- Cancer of the urethra. Not the first plan, as a rule, is difficulty urinating. Other possible signs are urethrorrhagia, purulent discharge, urethral pain, regional lymphadenitis, swelling of the penis and scrotum, fistula formation. Sometimes there is priapism. A tumor-like formation is palpated in the urethra.
Other urological diseases
Cystitis in men develops less frequently than in women, is diagnosed mainly after 4 years, is provoked by other pathologies of the genital organs and urinary tract. Pollakiuria, nocturia, stranguria, imperative urges, pain during micturition, terminal hematuria are typical. Cramping worse at the beginning and end of urination. In addition, a symptom can be observed in diseases accompanied by crystallization of urine:
- Salt diathesis. Possible cramps, increased urges, burning at the end of micturition. Signs arise or intensify against the background of physical exertion, drinking alcohol, eating disorders. In some cases, renal colic is determined. Secondary urate nephropathy develops against the background of other pathologies, such as gout.
- Sand in the kidneys. During movement, sand can injure the urethra and the overlying sections of the urinary tract, which is accompanied by the development of appropriate symptoms. There are dysuric disorders, a feeling of incomplete emptying of the bladder, back pain, the appearance of blood in the urine. Sometimes the symptoms resemble renal colic.
- Urolithiasis disease. Calculi often form in the kidneys and bladder. Manifested by constant or periodic pain, hematuria. With renal colic, extremely intense pain in the lower back occurs, radiating to the external genitalia, thigh, and iliac zone. Frequent urges are found, then - cramps, oliguria, flatulence, vomiting. Tachycardia, arterial hypertension, chills, low-grade fever are detected.
Diseases of the prostate
Dysuric phenomena, cramps, stranguria, weakening of the jet, the need for straining are often observed in diseases of the prostate:
- Prostatitis. For an acute process, pain during urination is more typical. In chronic prostatitis, patients complain of burning sensation in the perineum and urethra, sexual dysfunction, and increased fatigue. Pathology often develops against the background of specific infections.
- Sclerosis of the prostate. It is formed as a result of circulatory disorders, hypoandrogenism in male menopause. The leading role in the clinical picture is occupied by urination disorders: frequent urge, weak stream, cramps, feeling of incomplete emptying. Sexual dysfunction is noted, hematospermia is possible.
- Prostate cancer. Symptoms are nonspecific. Urination is speeded up, the onset of micturition is difficult. Patients complain of soreness, burning during ejaculation and urination, increased urges, episodes of incontinence. Hematuria and hematospermia, pain in the lower abdomen, perineum and lower back, erectile disorders are determined.
Other andrological pathologies
Rezi when urinating can be observed in men with balanoposthitis. More pronounced in the catarrhal form of the disease, accompanied by intense pain, excruciating itching, swelling of the head and prepuce. With epididymitis, a symptom is present if testicular inflammation is a consequence of venereal urethritis. The manifestations of STIs are supplemented by edema, hyperemia, and pain in the groin area.
Allergy
Sometimes cramps are the result of allergic reactions. The allergens are latex, lubricant components, cosmetics, residues of washing powder and rinse aid on underwear. When trying to protect against STIs with STI drugs, the symptom may be due to both allergies and mucosal damage from the use of untested drugs or chemicals.
bladder ultrasound
Diagnostics
The urologist-andrologist is engaged in establishing the cause of pain. During the conversation, the doctor asks the man when the symptom appeared, with what manifestations it was combined. The specialist studies the dynamics of the development of the disease, identifies possible provoking factors. Then he conducts an external examination, paying attention to the state of the meatus, prepuce and head, the presence of edema, hyperemia and other changes in the genital organs. By palpation, the urologist detects tumor-like formations, regional lymphadenitis. Additional examination includes the following procedures:
- Finger examination of the prostate. The doctor palpation examines the prostate gland through the rectum. The technique allows you to evaluate the shape, size and uniformity of the structure of the body. It is used to diagnose volumetric formations. It makes it possible to suspect inflammation on the basis of pain on palpation and an increase in the size of the gland.
- Ultrasonography. Ultrasound of the urethra is a safe, non-invasive basic examination used to assess the condition of the urethra, detect injuries, stones and foreign objects. Ultrasound of the bladder is informative for cystitis, cystolithiasis. On ultrasound of the kidneys, all types of stones, hydronephrosis due to blockage with a calculus and other changes are visible. In diseases of the prostate, ultrasound of the prostate is indicated.
- Radiation diagnostics. Retrograde urethrography is considered the most accurate way to diagnose urethral injuries. To increase the information content, it is supplemented with excretory urography. X-ray-positive calculi are clearly visible on the survey pictures. To detect soft uric acid and protein stones, excretory urography or computed tomography is prescribed.
- Endoscopic methods. During ureteroscopy, the position of a foreign body or calculus, the state of the surrounding tissues are determined, and, if possible, removal is carried out. To confirm the blockade of the kidney or ureter in renal colic, chromocystoscopy is performed. In chronic cystitis without exacerbation, cystoscopy is sometimes performed. In the process of endoscopic examinations, according to indications, material is taken for morphological analysis.
- Other techniques. With obstruction of the urethra, urodynamic studies are indicative. Men with suspected prostate cancer are prescribed an extended examination, including transrectal or saturation biopsy, prostate MRI, chest X-ray, and skeletal bone scintigraphy.
- Laboratory tests. Confirmation of STIs is made by microscopy, microbiological examination, RIF, ELISA or PCR. With nonspecific inflammatory lesions of the urinary tract, bacteria, leukocytes, and erythrocytes are found in the urine. In men suffering from prostate diseases, determine the level of PSA. Biopsy specimens are studied during cytological or histological analysis.
Treatment
Conservative therapy
The list of therapeutic measures depends on the cause of pain during urination. The main role in the treatment of infectious and inflammatory processes is played by antimicrobial drugs. For nonspecific infections, agents from the group of cephalosporins, nitrofurans, fluoroquinolones, or macrolides are used. For STDs, antimicrobial, antiprotozoal and antifungal drugs are used, selected taking into account the sensitivity of the pathogen.
Depending on the nature of the disease, men are additionally prescribed immunocorrectors, intravesical instillations, medicinal microclysters, and various methods of physiotherapy. Patients with traumatic injuries and foreign objects may require analgesics, NSAIDs, tranquilizers, sedatives and hemostatic agents. In case of injury, catheterization is performed. For cancer, radiation therapy and chemotherapy are used.
Surgery
Men with pain during urination undergo the following surgical interventions:
- Foreign objects and injuries: primary urethral suture, delayed urethral repair, transurethral or surgical removal of a foreign body.
- Urolithiasis: contact and remote cystolithotripsy, ureterolithotripsy and nephrolithotripsy, nephrolithotomy, pyelolithotomy, ureterolithotomy, cystolithotomy.
- Sclerosis and prostate cancer: transurethral resection, radical prostatectomy, prostate brachytherapy, bilateral orchiectomy for hormone-dependent neoplasms.