Persistent Burning Sensation During Urination: Possible Causes and Solutions

Q: Persistent Burning Sensation During Urination: Possible Causes and Solutions

Hello： If you're not feeling well, you should consider visiting the infectious disease department at the hospital. <br>Wishing you good health. <br>Drink plenty of water, avoid spicy and irritating foods, and refrain from sugary drinks.

The burning sensation during urination has not improved?

Hello Doctor: After engaging in high-risk sexual behavior on December 10, I have been experiencing pain during urination and a burning sensation on the glans after urination, but there is no discharge or pus.
On December 16, I visited a urologist who performed a urinalysis and found no issues, including no hematuria.
He prescribed me Dicyclomine 10 mg and Phenazopyridine 100 mg for five days.
During the medication period, my symptoms improved, but shortly after finishing the medication, the symptoms returned.
Although urination is no longer painful, I still experience a burning sensation on the glans after urination, along with some discomfort in my lower back and slight joint pain.
I do not have a fever.
Today, December 30, I went back to see the same doctor.
He asked me to do another urinalysis and a lumbar X-ray, which also showed no issues, including no stones.
He prescribed me the same medications for another seven days and told me to take them.
I am worried that the symptoms will persist after finishing the medication.
I have been suffering for over three weeks now.
Could you please advise me on what symptoms this might indicate? If the symptoms remain after the medication, should I consider seeing an infectious disease specialist?

Mr. Ou, 20~29 year old female. Ask Date: 2017/12/30

Dr. Du Shixi reply Urology

Hello: If you're not feeling well, you should consider visiting the infectious disease department at the hospital.
Wishing you good health.
Drink plenty of water, avoid spicy and irritating foods, and refrain from sugary drinks.

Reply Date: 2017/12/30

More Info

The symptoms you are experiencing, particularly the persistent burning sensation during urination and discomfort in the genital area, can be quite distressing. Based on your description, it seems that you have already undergone some initial evaluations and treatments, but the symptoms have not fully resolved. Here’s a comprehensive overview of potential causes and recommendations for further action.

Possible Causes
1. Urinary Tract Infection (UTI): Although your urine tests came back normal, it's important to note that some infections may not always show up in standard tests, especially if they are caused by atypical bacteria or if the infection is localized. Symptoms of a UTI can include burning during urination, frequent urination, and lower abdominal pain.

2. Urethritis: This is inflammation of the urethra, which can be caused by infections (including sexually transmitted infections) or irritants. The absence of discharge does not rule out urethritis, particularly if it is non-gonococcal.

3. Prostatitis: In males, inflammation of the prostate gland can cause similar symptoms, including burning during urination and pelvic pain. This condition can be acute or chronic and may require specific treatments.

4. Interstitial Cystitis: This is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. It can cause burning sensations and is often misdiagnosed as a UTI.

5. Nerve Irritation or Damage: Given your mention of back pain, it's possible that nerve issues related to the lumbar region could be contributing to your symptoms. Nerve irritation can lead to referred pain in the genital area.

6. Medication Side Effects: While medications like Dicyclomine and Phenazopyridine can help alleviate symptoms, they may not address the underlying cause. If symptoms return after stopping the medication, it may indicate that the root issue has not been resolved.

Recommendations
1. Follow-Up with a Specialist: Since your symptoms persist despite treatment, it may be beneficial to consult a urologist or an infectious disease specialist. They can provide a more thorough evaluation and consider additional tests, such as a cystoscopy, to examine the bladder and urethra directly.

2. Consider STI Testing: If you have engaged in high-risk sexual behavior, it may be prudent to undergo comprehensive STI testing, including tests for chlamydia and gonorrhea, even if initial tests were negative.

3. Pain Management: Discuss with your doctor the possibility of using pain management strategies, including topical anesthetics or other medications that may help alleviate discomfort.

4. Lifestyle Modifications: Staying well-hydrated, avoiding irritants (such as caffeine, alcohol, and spicy foods), and practicing good hygiene can help manage symptoms.

5. Keep a Symptom Diary: Documenting your symptoms, including their frequency, intensity, and any potential triggers, can provide valuable information for your healthcare provider.

6. Seek Immediate Care if Symptoms Worsen: If you experience worsening symptoms, such as fever, chills, or severe pain, seek medical attention promptly.

Conclusion
Persistent burning during urination can stem from various causes, and it’s crucial to continue seeking medical advice until you find a resolution. If your current physician is unable to provide answers, don’t hesitate to seek a second opinion. Your health and comfort are paramount, and there are specialists who can help you navigate these symptoms effectively.

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