Cramps When Urinating In Women : Causes, Symptoms, Diagnosis & Treatment

• Why Do Women Get Cramps When Urinating
• Cystitis
• Urethritis And Stis
• Other Urological Diseases
• Women's Diseases
• Diagnostics
• Treatment
• Conservative Therapy
• Surgery

Pain during urination in women is provoked by cystitis, urethritis, and some other diseases of the kidneys, urethra and bladder. They are a hallmark of STDs. They are observed in a number of diseases of the female genital area. Often combined with pain, burning, other dysuric disorders, changes in urine. The cause of the symptom development is established according to the survey, gynecological examination, laboratory and imaging techniques. Antibiotics, anti-inflammatory drugs, non-drug methods, surgical interventions are used.

Why do women get cramps when urinating

Cystitis

They are considered the most common cause of the symptom. Resi is more pronounced in the acute course of the disease. Observed at the end of urination, combined with pain. Other signs include frequent imperative urges every 5-15 minutes, the release of small portions of cloudy urine, terminal hematuria, pain over the womb. When the neck of the detrusor is involved, intense pain, urinary retention, and urinary incontinence are noted.

In the chronic course during the period of remission, the symptom is absent. With exacerbation, the picture corresponds to the acute form. Cystitis in women differs somewhat in clinical manifestations depending on the endocrine status and the cause of occurrence:

• In pregnant women. There are frequent painful mictions, imperative urges. In severe cases, moderate or severe pain above the pubis, turbidity of urine, and general intoxication are detected. After childbirth, urinary retention often develops.
• With a climax. Symptoms resemble those of typical cystitis. Urination becomes more frequent up to 20-3 times a day. Patients complain of constant pain in the lower abdomen, a feeling of incomplete emptying of the detrusor, a sharp pain at the end of micturition. Typically relapsing course.
• Postcoital. It is provoked by sexual contacts, debuts in the interval from several hours to 1.5 days after intercourse. It is manifested by cuts, burning and pains that occur in the process of urination and intensify during its completion. The general condition is satisfactory.

Radiation cystitis occupies a special place among the inflammatory lesions of the bladder. The early form manifests itself during or after a short period of time after the completion of radiation therapy. It is characterized by urgent urges, frequent urination, responds well to treatment. With late radiation injury, intense pain, constant dysuria, frequent micturition, and persistent incontinence are observed.

Urethritis and STIs

Inflammation of the urethra in women is specific or nonspecific. Nonspecific urethritis is provoked by diagnostic manipulations, prolonged catheterization, casual sexual contacts. Accompanied by pain, burning, itching, pain during urination. Often complicated by cystitis. For specific urethritis, a combination with vaginitis is characteristic. The clinical picture is determined by the type of pathogen:

• Gonorrhea. Debuts 5-1 days after sexual contact. Cutting, soreness and burning are combined with profuse yellowish or white discharge from the vagina. Perhaps an increase in inguinal lymph nodes. In some women, gonorrhea is complicated by the development of bartholinitis with intense pain, signs of intoxication.
• Chlamydia. The duration of the incubation period is approximately 3 weeks. Cramps during urination are complemented by turbidity of urine, burning, pain in the vulvar zone. Sometimes there is a slight hyperthermia. With chronicity, in some cases, there is an upward spread of infection with pain in the lumbar region and lower abdomen.
• Mycoplasmosis. Signs appear after 2 weeks. Pain during micturition, non-intense raw pain in the vagina, transparent mild discharge are detected. Some patients have menstrual irregularities, abdominal pain.
• Trichomoniasis. The incubation period is 5-14 days. Women complain of itching in the area of ​​the vagina, labia and urethra. Discharge is copious, frothy, yellowish or greenish, with a pronounced unpleasant odor.
• Ureaplasmosis. Often asymptomatic. Clinical manifestations are non-specific, include burning, discomfort, pain during urination, an increase in the volume of whites. Recurrent cramps, persistent vaginitis and adnexitis, infertility or miscarriages indicate a transition to a chronic form.

Candidiasis in women is not considered as a sexual infection, it develops against the background of taking antibiotics, reduced immunity, endocrine disorders. As a rule, it proceeds in the form of vaginitis with curdled discharge. Candidal urethritis is rare. The involvement of the urethra is evidenced by dysuria, painful frequent urges, pain and burning during urination.

Cramps when urinating in women

Other urological diseases

Cutting sensations in 80% of cases accompany paraurethral cysts. Complemented by frequent urges, burning, pain, mucous discharge from the urethra. There may be an increase in symptoms after sexual contact. With urachus cysts, cramps appear against the background of a breakthrough of the formation into the bladder. Frequent urination is combined with general hyperthermia, hematuria, an unpleasant odor and impurities of pus in the urine.

In women with urolithiasis, a violation is observed during renal colic. The formation of this condition is evidenced by very strong cramping pains in the lower back, forcing patients to rush about in an attempt to alleviate their condition. Frequent urge to urinate is replaced by oliguria, pain in the urethra, vomiting, false urge to defecate. Shock may develop. With sand in the kidneys, the manifestations are usually less pronounced. Symptoms occur when the urinary tract is traumatized by microcalculi.

Women's diseases

Urinary incontinence during menopause is a consequence of childbirth and past gynecological diseases, changes in hormonal levels, weakening of the supporting and fixing structures of the small pelvis. Symptoms often appear a few years after menopause. Women complain of burning and dryness in the vulva, pollakiuria, nocturia, pain in the urethra when urinating. Then the listed manifestations are supplemented by progressive incontinence.

Cramps, soreness and burning in combination with constant leakage of urine, maceration of the genital organs and the perineum are noted with total female hypospadias. The symptom is detected in early childhood and persists throughout life. Sometimes cramps during urination accompany acute vaginitis. Pain during sexual intercourse, unusual leucorrhea, burning and itching in the vagina are noted.

Diagnostics

Determining the nature of the pathology is the responsibility of the urologist. If you suspect the presence of diseases of the reproductive sphere, a gynecologist is involved in the examination. The specialist determines when the symptom first appeared, how often it worries, what circumstances it provokes, what manifestations it is combined with. The examination plan for women with urination cramps includes the following diagnostic procedures:

• Gynecological examination. The doctor assesses the condition of the external genitalia and meatus. It reveals signs of inflammation, the presence of pathological secretions, and other changes. Examines the vagina and cervix with the help of gynecological mirrors, conducts a bimanual examination. During the examination, the specialist receives a comprehensive picture of the state of the reproductive system, excludes gynecological diseases.
• Ultrasonography. In cystitis, a thickened edematous wall of the detrusor is visualized on an ultrasound of the bladder. The technique allows diagnosing an urachus cyst, excluding cystolithiasis and neoplasms. Ultrasound of the kidneys makes it possible to determine the presence of stones, to assess the state of the pyelocaliceal system. When performing ultrasound of the small pelvis, diseases of the uterus and appendages are determined.
• Beam techniques. Radiopositive stones are detected during survey urography. Intravenous urography is prescribed to detect X-ray negative calculi, to exclude other causes of renal colic. To clarify the size and localization of stones, CT of the kidneys is performed. With inflammation of the detrusor, in some cases, cystography is performed.
• Endoscopic methods. With recurrent cystitis during remission, cystoscopy is performed to determine the morphological form of inflammation, exclude other diseases, and take a biopsy. During chromocystoscopy during renal colic, indigo carmine is not released from the side of the blockade or appears late. Sometimes a strangulated stone, hemorrhages, swelling of the mouth of the ureter are visualized. With hypospadias, video colposcopy is indicated.
• Laboratory tests. They are the main method for diagnosing STIs. Depending on the type of infection and the clinical situation, microscopy of smears and discharge, inoculation on nutrient media, ELISA, PCR are prescribed. With cystitis in the urine, bacteriuria, proteinuria, hematuria, leukocyturia are found.

Women with menopausal incontinence, chronic cystitis may require uroflowmetry and other urodynamic studies. To exclude other developmental anomalies, patients with hypospadias are prescribed not only ultrasound of the pelvic organs and radiopaque studies of the urinary tract, but also radiography of the sacrum, lumbar spine.

Urogynecologist's consultation

Treatment

Conservative therapy

The plan of therapeutic measures is drawn up taking into account the nature of the disease, accompanied by pain during urination. In inflammatory pathologies, it is recommended to avoid hypothermia. Women suffering from urolithiasis are prescribed a special diet. The following drug and non-drug methods are used:

• Antimicrobial therapy. It plays a leading role in urethritis and cystitis of infectious etiology. Phosphonic acid derivatives, nitrofurans, and fluoroquinolones are effective in nonspecific processes. The scheme is adjusted after receiving the results of sowing with the determination of antibiotic susceptibility. For specific infections and candidiasis, antibacterial, antitrichomonas and antifungal agents are used.
• other medicines. Apply uroseptics and NSAIDs. Women with renal colic are intramuscularly injected with antispasmodics and painkillers. With prolonged attacks, it is recommended to irrigate the lower back with chlorethyl, the introduction of local anesthetics in the area of ​​the round uterine ligament. Phytopreparations are useful both for cystitis and for KSD, help to improve the condition of the urinary system.
• local therapy. With cystitis, intravesical instillations and physiotherapy are prescribed. With renal colic, thermal procedures, electropuncture and acupuncture are carried out. With small stones, vibration therapy, ultrasound and diadynamic therapy are effective. In case of incontinence, special exercise therapy complexes, electrical stimulation, urogynecological pessaries are recommended.

Surgery

Operative interventions are required for women with KSD. In most cases, minimally invasive techniques are used: contact nephrolithotripsy or ureterolithotripsy, percutaneous nephrolitholapaxy. Indications for laparoscopic and open operations are infectious diseases of the urinary system and pathologies of the musculoskeletal system, which do not allow the patient to be given the desired position. Perform nephrolithotomy, pyelolithotomy or ureterolithotomy.

The simplest and most effective technique for incontinence in women is the installation of slings. In severe genital prolapse, more complex interventions are required to restore the pelvic floor: laparotomic and laparoscopic sacrovaginopexy, Manchester operation, etc. In total hypospadias, plastic surgery of the vagina, urethra, and detrusor neck is performed.