Urethral Pain: Causes, Symptoms, and Treatment Options

Q: Urethral Pain: Causes, Symptoms, and Treatment Options

Hello： Since the symptoms have persisted for a month, if you are seeing the same physician, they should order additional tests to determine the cause of the recurrent infection. <br>Additionally, sexual activity may also play a role. <br>If you have been attentive to lifestyle fa

Pain at the urethral opening?

Hello Doctor, I have been experiencing pain at the urethral opening since May 17, which led me to visit a urology clinic.
The symptoms include sharp burning pain during urination, slight pain immediately after urination, and intermittent sharp pain (which feels like being pinched with a fingernail) when not urinating.
The frequency varies; sometimes the pain occurs every few seconds (lasting 5-10 seconds each time) and sometimes every 1-10 minutes.
After a routine urinalysis, the doctor indicated inflammation and prescribed medication, including:
- A006271100: Limo Berlot pain relief tablets
- AC13181100: "Veterans" Uro-Ning tablets 500 mg
- AC20092100: "Yongxin" Shutan tablets (Oxybutynin)
- AC36425100: Jafamycin capsules 500 mg (Ciprofloxacin)
The next day, my symptoms remained the same, and I noticed blood on the toilet paper after wiping.
Therefore, on May 18, I returned for a follow-up, and the doctor prescribed an additional medication:
- AC24282100: Tranq capsules 250 mg (Tolterodine)
During my follow-up on May 24, the doctor conducted another urinalysis and noted that the inflammation was unchanged, so he changed my medication and administered a self-paid antibiotic injection (I did not note the name).
The medications prescribed were:
- A006271100: Limo Berlot pain relief tablets
- AC20092100: "Yongxin" Shutan tablets (Oxybutynin)
- AC48892100: "Xindong" Cixin capsules 100 mg
On June 9, the pain persisted, and unable to tolerate it, I went to Chengqing Hospital's urology department.
After another urinalysis, the doctor diagnosed me with cystitis accompanied by hematuria and prescribed:
- A006271100: Limo Berlot pain relief tablets
- AC067471G0: Xinbaoxin capsules
- BC257091G0: Buscopan coated tablets 10 mg
During my follow-up on June 11, the pain remained the same.
The doctor conducted a urinalysis (indicating some inflammation but better than before) and a urine culture (results available on June 19, which showed no bacteria).
The medications prescribed that day were:
- A020707100: Deparin tablets (Acetaminophen)
- AC249641G0: "Xinghui" Mengke tablets
- BC257091G0: Buscopan coated tablets
On June 19, the frequency of pain decreased (about once every 10-30 minutes).
After another urinalysis, the doctor noted only slight inflammation, suggesting it was manageable.
He advised me to continue taking the medications for another seven days:
- A020707100: Deparin tablets (Acetaminophen)
- AC249641G0: "Xinghui" Mengke tablets
- BC257091G0: Buscopan coated tablets
On June 23, due to an increase in pain frequency (about every 5-10 minutes), I felt anxious it might return to the initial severity, so I returned to my previous urology clinic.
The doctor conducted a urinalysis and noted inflammation.
I inquired if it could be stones, and the doctor mentioned that stones would typically cause back pain, which I did not have.
The prescribed medications were:
- A006271100: Limo Berlot pain relief tablets
- AC20092100: "Yongxin" Shutan tablets (Oxybutynin)
- AC48892100: "Xindong" Cixin capsules 100 mg
By the morning of June 26, the pain persisted at the same frequency (every 5-10 minutes), and unable to bear it, I switched to the Infectious Disease department at Wuchi Tzu Chi Hospital.
After reviewing my symptoms, the doctor suggested it was likely not cystitis and recommended further examination in either gynecology or urology.
I then visited the gynecology department, where the doctor performed a pelvic exam and abdominal ultrasound, both of which were normal.
However, after a urinalysis, the doctor suspected cystitis and prescribed medication for six days, advising that if it did not improve, I should return to urology for a check for urinary stones:
- Uroprin (Uroclean coated tablets)
- Someprim (Somaipelin)
May I ask if I should proactively discuss what tests to undergo during my next visit? (I have informed each different doctor about my previous consultations and requested them to review my medication records from my health insurance card.
Honestly, I feel disheartened after so many visits; I am constantly awakened by pain at night.
I can only confirm that the pain is not from the vaginal area but rather around the urethral opening and inside the urethra, which I have endured for a long time.
I have considered going to the emergency room several times but thought it better to endure than waste medical resources.
After being tormented for so long, I have cried, but I can only cooperate with the doctors.
I have listened to the advice for cystitis patients and have been researching online.
I drink about 3000-3600cc of water daily, and my diet has always been normal—vegetarian, light, and low in salt.
If the pain occurs frequently during the day, I cannot lie down or sit comfortably; I cannot do anything.
At night, I am often awakened by pain while trying to sleep...) Please, doctor, assist me and provide some advice...
Can I proactively suggest other tests? What tests might I need? How should I communicate with the doctor to help arrange for these tests?

Xiao Ming, 20~29 year old female. Ask Date: 2018/06/26

Dr. Du Shixi reply Urology

Hello: Since the symptoms have persisted for a month, if you are seeing the same physician, they should order additional tests to determine the cause of the recurrent infection.
Additionally, sexual activity may also play a role.
If you have been attentive to lifestyle factors and still experience infections (as of 6/23) and have had episodes of hematuria, further examination is necessary.
Fortunately, current medications are quite effective, and it is uncommon for young individuals to have prolonged issues.
I recommend seeking treatment at a medical center, and it is important to communicate with your physician about factors such as fluid intake and medication adherence.
Furthermore, urine tests should not be conducted during menstruation, as this can affect the results.
Wishing you good health.
Here are some precautions regarding urinary tract infections for your reference:
1.
Develop good personal hygiene habits:
(1) Wear cotton underwear.
(2) Women should wipe from front to back after using the restroom.
(3) Prefer showers over baths or saunas.
(4) Infants and young children should have their diapers changed frequently to maintain cleanliness and dryness.
2.
If there are no specific medical restrictions, daily fluid intake should be between 2000 to 3000 cc.
3.
Avoid holding urine for extended periods.
4.
With the current hot weather, do not stay in humid environments for too long.

Reply Date: 2018/06/26

More Info

Urethral pain, characterized by burning or sharp sensations during urination, can be distressing and debilitating. Your symptoms, which include pain during urination, intermittent sharp pain when not urinating, and the presence of blood in your urine, suggest a possible urinary tract infection (UTI) or other underlying conditions. Given your extensive medical history and the treatments you've already undergone, it's understandable that you're feeling frustrated and anxious about your situation.

Causes of Urethral Pain
1. Urinary Tract Infection (UTI): This is the most common cause of urethral pain. UTIs can cause inflammation of the urethra, leading to burning sensations during urination and sometimes blood in the urine.

2. Cystitis: Inflammation of the bladder, often associated with infections, can also lead to similar symptoms.

3. Urethritis: Inflammation of the urethra itself, which can be caused by infections, irritants, or sexually transmitted infections (STIs).

4. Kidney Stones: Although you mentioned that you do not have back pain, kidney stones can sometimes cause referred pain to the urethra.

5. Interstitial Cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain.

6. Pelvic Floor Dysfunction: Tension or dysfunction in the pelvic floor muscles can lead to pain in the urethra and surrounding areas.

Symptoms to Monitor
- Pain Characteristics: Note if the pain is sharp, dull, constant, or intermittent.

- Urination Patterns: Frequency, urgency, and any changes in the color or odor of urine.

- Associated Symptoms: Fever, chills, or any other systemic symptoms that may indicate a more serious infection.

Treatment Options
1. Antibiotics: Since your urine tests indicated inflammation, antibiotics are often the first line of treatment for UTIs or urethritis. Ensure you complete the full course of any prescribed antibiotics.

2. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort. Your doctor may also prescribe stronger pain medications if necessary.

3. Hydration: Continue to drink plenty of fluids, as this can help flush out the urinary system.

4. Avoid Irritants: Stay away from caffeine, alcohol, spicy foods, and artificial sweeteners, which can irritate the bladder.

5. Follow-Up Testing: If symptoms persist, further testing may be necessary. This could include:
- Urine Culture: To identify specific bacteria and determine the appropriate antibiotic.

- Ultrasound or CT Scan: To check for kidney stones or other structural issues.

- Cystoscopy: A procedure where a thin tube with a camera is inserted into the bladder to look for abnormalities.

Communicating with Your Doctor
When you return for your next appointment, it’s important to communicate your concerns clearly. Here are some tips on how to approach the conversation:
- Be Direct: Explain that your symptoms have not improved despite treatment and that you are experiencing significant discomfort.

- Request Specific Tests: Politely ask if further testing, such as a urine culture or imaging studies, could be beneficial in identifying the underlying cause of your pain.

- Express Your Concerns: Share your feelings of frustration and anxiety regarding the ongoing pain and how it affects your daily life.

Conclusion
Urethral pain can stem from various causes, and it’s crucial to identify the underlying issue to provide effective treatment. Given your ongoing symptoms and the impact on your quality of life, advocating for further evaluation and testing is appropriate. Remember, you are your best advocate in your healthcare journey, and it’s essential to communicate openly with your healthcare providers. If necessary, consider seeking a second opinion from a urologist or a specialist in pelvic pain to explore additional treatment options.

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