Pain in the urethra is accompanied by urethritis, stones, foreign bodies, traumatic injuries, benign and malignant neoplasms of the urethra. It is detected in conditions accompanied by chronic obstruction of the urethra, some andrological and gynecological pathologies. Most often it has a cutting character, associated with urination. To establish the cause of the symptom, complaints are collected, an external examination, imaging and laboratory studies are carried out. Treatment includes antibacterial agents, NSAIDs, immunostimulants, physiotherapy, and surgical interventions.
Urethritis is a group of diseases, usually of an infectious nature. Less commonly, pathology develops against the background of allergies, toxic or radiation exposure. The main manifestations are itching, burning and pain during urination, pathological discharge from the urethra. The clinical picture varies somewhat depending on the type of pathogen:
Nonspecific bacterial, less often specific inflammation occurs not only in adults, but also in young patients. Pathologies are most susceptible to patients aged 2-4 years. Urethritis in children is manifested by pain and burning during the passage of urine, sometimes by dull pulling pain in the lower abdomen. There may be sudden painful urges, frequent urination, including at night.
Men are more often affected. Secondary calculi predominate, descending into the lumen of the urethra from the kidneys or bladder. Traumatization of the walls of the organ by a moving stone is accompanied by a sudden intense sharp pain. Difficulties in urination, weakening and dispersion of the jet, hematuria are observed. Complete obturation is manifested by acute urinary retention. Men with posterior urethral calculi complain of pain when sitting and walking.
Foreign objects in the urethra are more common in children and young men. The first category introduces foreign bodies out of curiosity, the second - during masturbation. With small smooth objects, slight soreness and discomfort are observed, which gradually decrease, but reappear with sexual arousal and urination.
Sharp and large objects cause severe pain, strong urges, marked anxiety, hematuria, and with obstruction of the urethra - bloody discharge. Subsequently, urethritis often develops with pain and burning in the urethra, perineum and penis, general hyperthermia, intoxication syndrome.
Among the victims with injuries, men also predominate. In half of the cases, pathology occurs with severe pelvic fractures. An incomplete rupture is characterized by acute pain, cramps, difficulty urinating, blood in the first portion of urine, hematomas of the scrotum and perineum. With complete breaks, urine does not depart. Patients complain of a sharp pain in the urethra and lower abdomen, ineffective imperative urges.
Pain in the urethra
Epithelial (warts, papillomas) and non-epithelial (fibromas, myomas, angiomas, etc.) benign tumors are asymptomatic for a long time. Then, itching and burning, discomfort and pain during urination, changes in the stream, contact spotting and blood impurities in the urine appear and slowly increase. When infected, the pain syndrome increases, pain is noted. Women may have dyspareunia.
Polyps are more common in people over 45 years of age. Clinical manifestations resemble urethritis or cystitis. Burning and painful sensations in the urethra appear when passing urine, while walking and sexual intercourse. A type of polyp is a caruncle that develops in women during menopause. There is pain during and after the completion of urination, increased urge, splashing of the jet, sometimes - urethrorrhagia. Pathology is often complicated by prolonged severe cystitis and urethritis, severe dyspareunia.
Malignant tumors in men are characterized by difficulty urinating, the presence of compaction, urethrorrhagia, purulent discharge. Pain appears when the process spreads, radiates to the perineum, is combined with swelling of the penis and scrotum, inguinal lymphadenitis. In women with urethral cancer, pain and burning in the urethra, dyspareunia, urethrorrhagia, urinary incontinence are observed. With the transition of neoplasia to the vagina, pain occurs over the bosom.
Formed with valves and strictures of the urethra. Urethral valves are more common in early childhood, less common in adult men who have undergone urological surgery and manipulation. Patients are concerned about moderate pain during urination, jet lethargy, nighttime urges. Among patients with urethral strictures, there is a 2-4-fold predominance of men. Pain is an optional symptom that occurs against the background of weakening and splashing of the jet, a feeling of incomplete emptying of the detrusor.
Pain in the urethra and inguinal-iliac region, combined with incontinence, pollakiuria, dysuria, are noted in the complicated course of diverticula. Typically difficult, painful urination in an intermittent stream with persistent urge and leakage of urine even after emptying the bladder. Pyuria and hematuria are possible. Large diverticula make sexual intercourse difficult due to swelling and pain in the vagina.
Diagnosed in adolescent girls and menopausal women. Patients complain of a feeling of a foreign body, followed by burning and pain. In the area of the external opening of the urethra, a painful cyanotic or pinkish dense formation is detected. Painful frequent urges are noted, urinary incontinence is possible. With mucosal edema, acute ischuria develops.
Pain and pain in the urethra are accompanied by many diseases of the bladder:
Pain in the urethra is especially pronounced in acute prostatitis. It is combined with pain in the perineum and sacral area, sometimes radiating to the anus. Pain and increased urination are noted, urinary retention, and difficulty in defecation are possible. In chronic prostatitis, pain in the urethra, above the pubis, in the groin and perineum is aching, constant, and intensifies at the initial and final stages of urination.
Pain in the urethra with prostatitis in children appears during urination, is complemented by constant pulling pains and discomfort in the perineum, lower abdomen, extending into the scrotum and rectum. Along with prostatitis, pain in the urethra sometimes accompanies prostate cancer and prostate adenoma, which develop mainly in old age. Pain occurs during ejaculation or urination. Combined with pain in the pelvis, perineum, above the pubis, dysuria and ischuria.
In 80% of women with paraurethral cysts, frequent urges, soreness of the urethra, cramps, burning, mucous discharge from the urethra are observed. An elastic formation can be palpated in the meatus zone. Another cause of pain, severe discomfort, burning and pain when passing urine can be vestibulovaginal hypospadias.
Urethrocystoscopy
Diagnostic measures are carried out by a urologist. If necessary, patients are referred to an andrologist, gynecologist or oncologist. The specialist collects complaints, finds out the anamnesis of life, establishes the circumstances of the appearance and nature of painful sensations, the presence of other symptoms, the dynamics of the disease. Women are examined on a chair. According to indications, men are prescribed a digital examination of the rectum. The diagnostic plan includes the following procedures:
The list of therapeutic measures is determined by the characteristics of the pathological process:
In urological diseases, the following surgical methods are used:
Patients with prostate adenoma undergo transurethral resection, laser vaporization, or laser enucleation. According to the indications, a transvesical or retropubic adenomectomy is performed. For prostate cancer, various types of prostatectomy are used. Paraurethral cysts in women are removed by excision. In female hypospadias, non-surgical plasty using hyaluronic acid or urethral transposition is performed.