Pain during or
immediately after urination is a common reason for women to seek medical
attention. Frequent causes for this symptom include:
- Cystitis (bladder infection)
- Urethritis (infection of
the urethra)
- Herpes vulvitis
- Endometriosis
- Contact dermatitis
- Trauma
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Evaluation
- Document the onset and severity of symptoms, whether
the pain lasts throughout urination or just at the end (terminal dysuria),
and whether the pain is on the outside (vulva) or behind the pubic bone
(bladder)..
- Inspect the vulva, looking for signs of trauma, or the
open sores of herpes.
- Palpate the urethra and bladder, looking for the
tenderness of urethritis or cystitis.
- Lab tests may include
urine dipstick screening,
urine sediment microscopic analysis,
urine culture,
gonorrhea,
chlamydia, or herpes testing,
depending on the severity and type of symptoms.
- With classical symptoms, lab testing is sometimes
omitted.
- Some providers test the urine after completing therapy,
while others do not.
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Treatment
Treatment is based on the presumed cause of the pain.
Cystitis may be treated with such antibiotics as:
Urethritis is treated with antibiotics effective against
chlamydia and
gonorrhea, following
CDC
Guidelines.
Herpes is treated with
acyclovir.
Endometriosis is treated surgically or hormonally.
Contact dermatitis is treated by removal of the offending
organism,
anti-inflammatory medications, and
soothing baths. |