Why does it burn when I pee?

If you feel a burning sensation when you urinate, chances are that it is a urinary tract infection, but there are other possible causes as well

By Deb Hipp | Nov. 13, 2023 Medically reviewed by Leslie Greenberg, MD

If you experience burning with urination, you could have dysuria, the medical term for discomfort associated with urination. Urinary tract infections (UTIs) are common causes of burning with urination, but there could also be other underlying medical problems.

Key takeaways:

Painful urination is a common symptom of various causes that include infection, inflammation, prostate enlargement, and urethral constriction.
Typically, painful urination doesn’t require immediate medical attention.
Some causes of burning with urination resolve on their own, while others need treatment.
Treatment of painful urination depends on the underlying cause and may include antibiotics, pain medications, lifestyle changes, or surgery for kidney stones or an enlarged prostate.
Use coupons for painful urination treatments, like Cipro (ciprofloxacin), Macrobid (nitrofurantoin), and Bactrim (trimethoprim-sulfamethoxazole), to save up to 80%.

What causes burning during urination?

There could be various reasons why it burns when you pee. For females, it’s commonly caused by UTIs. Bladder infections are the most common type of UTI, but any part of the urinary tract can become infected and cause painful urination. That includes the urethra, ureters, and kidneys. For men, burning urination could be caused by prostate problems or urethritis, inflammation of the urethra. The medical term for pain with urination, regardless of when during the stream the pain is present, is called dysuria. Pain at the start of urination is a common symptom of a urinary tract infection. Pain after urination is a common indicator of a bladder or prostate problem.

Causes of burning and pain associated with urination are classified as either infectious dysuria or noninfectious dysuria.

Possible causes of infectious dysuria include:

Urinary tract infection
Bladder infection
Kidney infection
Urethritis
Vaginitis
Sexually transmitted diseases

Possible causes of noninfectious dysuria include:

Dehydration
Irritation or allergies from soaps, laundry detergents, or other personal care products
Kidney stones
Menopause due to shifting hormone levels that can cause vaginal dryness
Bladder spasms
Skin conditions
Cancer
Prostate swelling

“The seriousness of painful urination depends on the underlying cause,” says Christine Meyer, MD, a primary care doctor in private practice in Exton, Pennsylvania. “In many cases, it can be a temporary and treatable condition. However, if left untreated, some causes, such as untreated UTIs, can lead to more severe complications, including kidney infections.”

What does dysuria (painful urination) feel like?

Dysuria most commonly feels like a burning sensation before, during, or after urination. Symptoms can vary, however; some people with dysuria describe a stinging or itching sensation.

Men sometimes experience pain in the penis before and after urination. Symptoms in women can be internal or external.

Should I be worried about burning during urination?

Depending on the underlying cause, painful urination may resolve on its own or after treatment with antibiotics. However, “if burning with urination continues for more than a few days, you should seek medical attention since the causes of painful urination could be more serious,” says Dr. Meyer.

According to Dr. Meyer, possible complications of untreated painful urination can include the following:

Kidney infections
Recurrent UTIs
Scarring of the urinary tract
Chronic pain and discomfort
Spread of STIs (in cases caused by sexually transmitted infections)

“It’s important to seek medical attention if you have symptoms in addition to burning or pain with urination, such as fever, abdominal pain, back pain, or an abnormal discharge from the urethra or vagina,” says Milan Shah, MD, a board-certified urologist at PIH Health in Los Angeles, California.

“These could be harbingers of something a lot more serious going on,” says Dr. Shah. “Usually, if someone’s having symptoms that are systemic fevers and chills, vomiting, nausea, they would warrant more urgent or emergency attention.”

One of the most serious possible complications of untreated painful urination is urosepsis, a life-threatening bloodstream infection caused by an untreated, undertreated, or resistant urinary tract infection. Urosepsis could lead to renal failure, septic shock, and even death without immediate treatment.

Burning urination due to an STI, such as chlamydia or gonorrhea, requires medical attention and antibiotic treatment. A bladder stone also may require medical attention.

“If someone has a bladder stone, usually if it’s small, they may pass it. If it’s much larger, they’ll need surgery,” says Dr. Shah. “Until that stone is gone, that dysuria or that burning of the painful urination will likely not resolve. If it’s an infection, antibiotics can help resolve that burning after an appropriate course of treatment.”

“Depending on your symptoms and medical history, you may see a primary care physician, urgent care physician, urologist, gynecologist (for women), or an infectious disease specialist,” says Dr. Meyer. “If you experience severe symptoms or signs of a serious infection, consider going to the emergency room.”

How is the cause of painful urination diagnosed?

To diagnose the cause of painful urination, your healthcare provider will order a urine culture using a special kit with a cup, lid, and wipes for a “clean catch” urine sample collected at home or at the provider’s office. A urine culture identifies bacteria or other germs.

If you cannot urinate on your own, your healthcare provider can collect a urine sample by inserting a catheter (a thin rubber tube) into the bladder through the urethra. This is rarely performed, due to the discomfort encountered with the passage of the catheter. For women with vaginal discharge, a pelvic exam or examination of vaginal fluids is necessary. For men with penile discharge, a urine culture is usually sufficient to reveal which infection is present. Although a medical provider (or a patient) can obtain penile discharge with a swab and send it to a lab for evaluation, this is a rare occurrence.

Your healthcare provider may ask about your history of urinary tract infections or recent sexual activity to rule out or test for an STI. Other tests for burning urination may include an ultrasound of the bladder and kidneys or an examination of the inside of the bladder with a camera called a cystoscope.

How long does painful urination last?

Painful urination usually resolves within one or two days. If it doesn’t, make an appointment for an exam with your healthcare provider.

“Painful urination itself is not contagious,” says Dr. Meyer. “However, the underlying causes, such as certain STIs or urinary tract infections, can be contagious through sexual contact or close contact with infected individuals.”

How to treat painful urination

The best way to get rid of painful urination depends on the underlying cause. “Painful urination due to a urinary tract infection is commonly treated with antibiotics such as Cipro (ciprofloxacin), Macrobid (nitrofurantoin), and Bactrim (sulfamethoxazole-trimethoprim),” says Dr. Meyer.

Other antibiotics used to treat a UTI may include:

Amoxicillin
Keflex (cephalexin)
Levaquin (levofloxacin)
Monurol (fosfomycin)

If the cause of burning urination is dehydration, drinking more water may resolve painful urination. “Prostatitis that’s caused by infection can be treated with antibiotics, an alpha-blocker medication such as Flomax (tamsulosin) to improve urine flow, and nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen for pain,” says Dr. Shah.

“If someone has a sexually transmitted infection, they should treat the appropriate infection with the appropriate antibiotics needed,” says Dr. Shah. “If there is an offending agent such as soaps and perfumes or other personal care products, just discontinue the offending agent.” Surgery may be required if painful urination is caused by a urethral stricture or a narrowing of the urethra.

Most importantly, painful urination is treatable

The most common cause of pain when urinating is a UTI, for which antibiotics are the first line of treatment. Other less common causes include bladder or kidney infections, STIs, dehydration, and kidney stones. The cause of painful urination may resolve on its own without treatment. However, if painful urination continues, worsens, or is accompanied by fever, abdominal pain, back pain, or an abnormal discharge, it could be a sign of a more serious condition that requires medical treatment.

Only your healthcare provider can rule out infection or other serious health conditions. Visit your healthcare provider to determine the best treatment for painful urination.