Pain when passing urine can be very distressing. It ranges from just a feeling of warmth to feeling like you are passing razor blades. There are several different causes of pain passing urine in men. Here are five:
Urinary tract infection
This is an infection of the urine in the bladder called a cystitis. Although this is more common in women, it can also occur in men. Bacteria found on the skin climbs its way up the urethra (urine tube inside the penis) and into the bladder. The defense mechanism of the body is to pass the bacteria out along with the urine. However, sometimes not all the bacteria is passed out and it causes a bladder infection.
Patients who have a bladder infection will also experience urinary frequency, urinary urgency and other symptoms of infection like fever and body aches. Some patients also experience nausea. Bladder infections are easy to diagnose with a urine test and treated with antibiotics.
Bladder stones are stones that sit in the bladder. Most of these stones are small enough to be passed out along with the urine. However, because the edges of these stones can be sharp, they can cut and injure the urethra on the way out. This causes a sudden intense pain in the middle of the urine stream. However, the pain also fades very quickly. Sometimes, you can even hear the stone striking the side of the toilet.
Bladder stones may cause some blood to be in the urine. When the amount of blood is very small, the urine will not appear red. Instead it will look cloudy. Most of the time there is no need to treat bladder stones as they will pass out by themselves. If there is an infection, it needs to be treated. There are also medicines that can help you pass out the stones.
Although chlamydia can cause discomfort passing urine, it is usually very mild. In fact, some patients describe it as an “itch” rather than a pain. Chlamydia infections can also cause a thin clear to yellowish, greenish discharge from the penis. Again this can be so mild that the only clue is a stain on the shorts in the morning. Symptoms of chlamydia can develop from three days to two weeks after infection.
Chlamydia infections are easily detected with a urine test. It is also very easily treated with antibiotics.
Like chlamydia, gonorrhea infects the urethra and can be caught via both penetrative sex as well as oral sex. However, the symptoms usually develop faster. Also, the discomfort when passing urine is more severe with most patients describing it as actual pain.
Another clue that the infection is by gonorrhea is that the discharge is usually copious and very yellow. Some patients have to stuff tissues into their shorts just to absorb the discharge and prevent staining. Just like chlamydia, gonorrhea infections are easily detected with a urine test and treated with antibiotics.
This refers to an infection of the foreskin. When the foreskin is infected, inflamed and swollen, it will be painful when urine comes into contact with it. So unlike the situations described above where the pain is within the urinary tube, the pain during urination experienced by a patient with balanitis is actually on the foreskin. All sorts of bacteria and fungus can infect the foreskin.
Conditions that weaken the immune system like diabetes increases this risk. A tight foreskin can also tear more easily. The torn skin can cause a lot of pain and also is at a greater risk of infection.
Treating balanitis does not only involve treating the infection, but the underlying cause. If a patient has diabetes, his blood sugar should be adequately controlled. If the foreskin if too tight, the patient should consider a circumcision.
This article, which first appeared on Dr Tan’s blog, has been edited for length and clarity.