dysuria
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Introduction
Painful or difficult urination, generally related to inflammation of the lower genitourinary tract.
Etiology
- urinary tract infection (UTI): most common cause
- vulvovaginitis
- urethritis - generally sexually transmitted
- chemical irritation
- chemical irritants
- bubble baths
- feminine hygiene products
- contraceptive gels/foams
- mechanical irritation
- allergic reaction
- prostatitis
- urinary calculus
- tumor: bladder cancer
- postmenopausal atrophic vaginitis
- sexual abuse
- Reiter's syndrome
- lumbar disc herniation[3]
Epidemiology
- common in women
Laboratory
- urinalysis
- urine culture
- vaginal secretion
- tests for sexually transmitted diseases
- Chlamydia:
- Neisseria gonorrhoeae
- gram stain: intracellular Gm- diplococci
- culture on selective media
- GenProbe
- Herpes simplex
- Tzanck smear
- culture
- acute & convalescent serologies
Management
- discontinue use of offending agents
- treat urinary tract infection (UTI)
- sexually transmitted disease: treat patients & partners
- Pyridium 200 mg PO TID for 2 days (urinary analgesic)
- diet
- hydrate: 8-10 glasses of water/day
- cranberry juice acidifies urine
- some patients benefit from yogurt
- patient education
- void frequently
- discontinue use of diaphragm/pessary
- void after sexual intercourse