Burning and itching in the urethra after urination

Among the symptoms, the manifestation of which is located in the area of the genito-urinary organs and anogenital zone, burning after urination is noted much more often than other unpleasant sensations and, naturally, causes anxiety. And it is completely justified, since this symptom has many very serious causes.

[1], [2]

Causes of burning after urination

The specific causes of burning after urination are revealed in patients urologists, venereologists and gynecologists.

Although almost half of the cases of Chlamydia trachomatis infection (transmitted sexually) by  urogenital chlamydia  have a latent course, but with a weakened immunity, the burning symptom after urination and during the exercise can be observed in women (with the development of chlamydial vaginitis) and in men with lesions infection of the urethra, diagnosed in the form of  chlamydial urethritis. In this case, not only burning and pain after urination, affecting the genitals and internal genital organs, but also the allocation of a different nature, including with a hideous smell.

If a woman feels itching and burning in the vagina after urination or sexual contact, this may be due to inflammation, the pathogenesis of which is due to a response to the defeat of the cervico-vaginal epithelium by Gardnerella vaginalis bacteria (with the development of gardnerellosis or bacterial vaginosis) or the simplest Trichomonas vaginalis, when the detection of which is diagnosed with trichomoniasis. In addition, burning in the urethra after urination is possible with urogenital mycoplasmosis, the causative agent of which is Mycoplasma hominis and Mycoplasma genitalium.

Burning after urination with thrush, which doctors call vulvovaginal candidiasis or vaginal candidiasis, is a consequence of colonization of the vaginal mucosa with the yeast-like fungus Candida albicans.

Itching in the genital area, severe burning sensation during bladder emptying and after urination (with frequent imperative urges) are the first signs of  acute and chronic recurrent cystitis in women, to whose development such infectious agents as E. Coli, Klebsiella, Proteus, Staphylococcus are involved.

In the presence of a patient aged 35-40 years and older, discomfort, pressure, or recurring pain in the bladder, pelvis and lower abdomen, burning in the bladder after urination with a high probability indicates the presence of interstitial cystitis. The etiology and pathogenesis of this urological disease is still unknown, and among several versions the possibility of the autoimmune nature of the inflammatory process is considered.

In some cases, burning during urination and burning after urination in the morning are associated not with infection, but with high acidity of urine (pH <5.5-6), which can be with excess in meat ration and abnormalities of purine metabolism. In turn, this leads to an increase in uric acid and  urate diathesis in . By the way, urine in this pathology with a sharp odor and a darker, and complication is the formation of the bladder concrements -  urolithiasis, among the symptoms of which also appear itching and burning after urination.

Also, the cause of the appearance of this symptom may lie in too acidic urine with simultaneous ketoacidosis - the appearance in the urine of ketones, characteristic for patients with uncompensated diabetes mellitus (type I), as well as alcohol dependence. In the latter case, there may be a burning sensation when urinating after drinking beer and other alcoholic beverages drunk in large quantities the day before. And with type II diabetes due to the presence of sugar in the urine, the mucous membrane of the urethra loses moisture and becomes more sensitive to uric acid, which causes irritation of the urethral epithelium.

Often there are complaints of burning with urination after antibiotics taken longer than 7-10 days, and this is explained by the antimicrobial medication inhibition of obligate microbiota (in particular, Lactobacillus) cervical canal, vagina and distal urethra.

Risk factors

In principle, the key risk factors for the appearance of itching and burning during and after bladder emptying were named above, and this is:

• infections that are sexually transmitted;
• Candidiasis of the urogenital system;
• stones in the bladder;
• problems of the endocrine nature, including diabetes mellitus;
• prolonged antibacterial therapy.

There are also factors that create conditions for the manifestation of this symptom in women (pregnancy, childbirth, menopause) and men (condition of the prostate gland).

Burning after urinating in women

In addition to infections associated with STDs and ordinary vaginal candidiasis, in women, burning in the vagina after urination may appear due to focal or diffuse inflammatory processes in the appendages or lining the mucous membrane (endometrium).

And pain during sexual intercourse and burning of the labia after urination gynecologists associate with such factors as the same candidiasis, chlamydia or gardnerellez, as well as allergies to personal care products and vulvodynia - a chronic inflammation that affects the nerve endings of the labia and concentrates with entering the vagina, gradually spreading to the area of all genitals. Some experts separately distinguish vestibulitis - inflammation of the mucous membrane of the vestibule vestibule, which is manifested by swelling and reddening around the external opening of the urethra, in the region of the paraurethral passages and excretory ducts of the large (Bartholin) glands of the vestibule.

Dyspiration and burning when urinating women after sex is a problem of the postmenopausal period, the pathogenesis of which is due to atrophic changes in the vaginal mucosal epithelium (due to a decrease in the synthesis of estrogen) and  vaginal dysbiosis with menopause.

Burning in the perineum after urination in many cases is the result of skin irritation in contact with urine. Often, due to the constant influence of urine (especially if there is drip incontinence during physical exertion, coughing, sneezing or weakening of the detrusor of the bladder in old age) and high humidity in the perineal region, the skin pH may change and the natural protective barrier may break - with the appearance of dermatitis and the attachment of staphylococcal or fungal infection.

Burning after urination during pregnancy can be due to the same infections (trichomoniasis or bacterial vaginosis), simply during pregnancy the female organism is more susceptible to genitourinary infections. Thus, there is a tendency to develop vaginal candidiasis in pregnant women during the last trimester of gestation (when there is a leak of a small amount of urine under the pressure of the uterus on the bladder and the constant tension of the pelvic floor muscles).

Painful sensations and burning sensation when urinating after giving birth are noted when the woman in labor was sealed (in the crotch and / or vagina), and getting urine on them leads to local irritation and burning.

In most cases, burning with urination after cesarean section is associated with catheterization of the bladder.

[3], [4], [5]

Burning after urination in men

Burning in the head after urinating, as well as the appearance of cuts in the case of microscopy, can be a sign of any sexually transmitted infection, including gonorrhea, which develops due to the infection of Neisseria gonorrhoeae and leads to gonorrhea urethritis.

The same reasons - with damage to the bladder and urethra - is caused by burning and urination after sex in men.

But the pain in the groin and burning in the prostate after urination in most men are associated with signs of prostatitis and  diffuse changes in the prostate gland.

[6], [7], [8],

Consequences and complications

Among the complications of inflammation of the bladder is often called a potentially dangerous for the state of the kidneys, pyelonephritis, as well as infection in the bloodstream and the development of sepsis.

Recurrent urinary tract infections in some adults can cause renal scarring, which over time can lead to kidney hypertension and possible renal failure.

In pregnant women, urinary tract infections present a serious risk not only to the health of the mother, but also to the child.

The consequences of sexually transmitted infections include pregnancy pathologies, the birth of non-viable infants, premature birth, or complete disruption of reproductive functions. By the way, prostatitis in men can also be a consequence of these infections.

[9], [10], [11], [12], [13], [14], [15]

Diagnosis of burning after urination

To identify the cause of burning after urination, tests are required:

• general clinical analysis of urine;
• biochemical analysis of urine with the determination of pH and salts (urate, oxalate and phosphate);
• daily urine analysis;
• general and biochemical blood test;
• blood test for sugar content;
• IFA backtracks antibodies;
• PCR-analysis of blood (or urine) for the detection of DNA of pathogenic bacteria;
• smear (sowing) from the vagina to the microflora and STDs (in men - scraping from the urethra).

More information -  Examination of vaginal discharge

Instrumental diagnostics includes ultrasound examination of the bladder and urinary tract.

Taking into account the data of laboratory studies and visualization results, differential diagnostics is carried out with the definition of the main diagnosis, on the basis of which the treatment is prescribed.

[16], [17]

Treatment of burning after urination

In each case, the treatment of burning after urination is directed at the cause of its occurrence.

If urine is prescribed for high acidity, for example, potassium citrate or Blemaren, then with inflammation of the bladder the main focus is on drugs against the microbes that cause it -  Antibiotics for cystitis

On how to properly treat inflammation of the bladder, read the special materials -  Treatment of cystitis  and Suppositories against cystitis 

Antimicrobial therapy is also used for sexually transmitted infections. What drugs are used for infection with gonococci are detailed in the article -  Treatment of gonorrhea

Frequent  intravaginal drugs (suppositories) are used  to treat thrush and other infections, for more information, see -

• Suppositories from chlamydia
• Suppositories from thrush

Alternative treatment

With cystitis, folk treatment presupposes sedentary moderately hot baths with decoctions of medicinal plants (chamomile flowers of marigold or calendula, three-parted grass, sweet clover and St. John's wort, oak bark and cranberry leaves). The duration of such a procedure should not exceed 10-15 minutes.

Treatment with herbs includes ingestion of diuretic infusions, prepared from the ground part of the field horsetail, bearberry, sporicha (bird mountaineer). It helps in the inflammation of the urinary tract cranberry - in the form of mors, that is, diluted with water juice, which is recommended to take twice a day for 150 ml.

And in case of a yeast infection (candidiasis vulvovaginitis), rinses of the vagina (syringing) with the decoctions of the same herbs, as well as with weak solutions of antiseptics (hydrogen peroxide, furacilin) and soda solution (a teaspoon for a half cup of water) are applied.

[18], [19], [20], [21]

Prevention

First and foremost, prevention refers to infections that both men and women can get infected with unprotected sex, read more -  STI prevention methods

Women who periodically undergo gynecological examinations and promptly consult a doctor if they have problems with the genitourinary system are more likely to remain healthy.  

Forecast

It is clear that the prognosis can be positive only in the treatment of diseases that cause burning after urination. Absence of treatment or its incompatibility with the existing pathology leads to chronic inflammation and a sharp deterioration in the general condition.

[22], [23]