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Dysuria is a common problem that can be quite aggravating to deal with. Although most of the time, this signals some type of bacterial urinary tract infection, there are a number of other possible agents that could be leading to this discomfort.

In medicine, the term "dysuria" is a general medical term we use when we are describing constant burning after urination [1]. This can be a term used for both men and women but the underlying etiologies of what is causing the pain can differ quite dramatically depending on your sex. When a patient presents to the Emergency Room complaining of dysuria, usually the first thing that pops into the mind of any doctor is some type of urinary tract infection. Although this is the overwhelming favorite when it comes to explaining your symptoms, there are a number of other diseases that you should be aware of in order to avoid dysuria in the future [2]. 

Urinary Stones 

Another possibility besides urinary tract infections that could be causing your dysuria could be from urinary stones that have formed in your urinary tract. This is a problem that can occur in 5 percent of the female population but epidemiology studies are believed to underreport the true rates [3]. These stones can naturally happen due to dehydration or due to physiological abnormalities after multiple urinary tract infections [4].

It is important to make sure you have adequate fluid intake, especially if you are living in warm climates or have a history of renal problems. It is recommended to drink at least 2 liters of water a day. This simple intervention can reduce the concentration of your urine and prevent stones from ever forming. 

Mechanical Injuries 

Lifestyle choices can also be a reason why you may be experiencing dysuria. Mechanical injury to your bladder and urinary tract can lead to constant burning after urination after doing activities like biking, horseback riding or sitting for prolonged periods of time. Car seats, bike seats, and horse saddles are all hard surfaces that can make lead to damage to sensitive anatomy. It is also important to avoid wearing tight-fitting jeans for this same reason. In one study looking at the prevalence of dysuria in cyclists, it was determined that in a questionnaire sent to 114 cyclists, up to 40 percent of those who responded reported some type of urinary discomfort after cycling for as little as 2 hours [5]. Make sure you use padded seats and take breaks every 20 to 30 minutes to reduce the trauma on your urinary tract. 

Menopausal Changes 

Another common condition that women notice constant burning after urination would be if they are going through menopause. Hormonal changes drastically impact tissue along the lower urinary tract and even vaginal opening and can lead to substantial burning during urination. This cascade of symptoms is now referred as the genitourinary syndrome of menopause (GSM) and is extremely common. Studies show that up to 67 percent of menopausal women note urinary changes during menopause. It is believed that the symptoms arise from decreased levels of estrogen circulating around the body when women enter menopause. Estrogen usually maintains the elasticity of the vaginal canal but as levels drop off after menopause, the elastic and moist tissue begins to dry out and begin to irritate the patients. Quality of life levels drop as expected but thankfully, treatment options are available. The use of vaginal lubricants and vaginal estrogen creams can help improve the turgidity of the vaginal tissue and alleviate the dysuria. [6]

Frequent Sexual Intercourse 

Another unfortunate activity that can lead to constant burning after urination would be due to having too much sex. Repetitive insertions using penises or sex toys can be quite detrimental to the health of the delicate tissue lining the vaginal canal and can cause women to experience dysuria for even a few days after their sexual encounter. This mechanical trauma can be easily avoided by either reducing the frequency of sexual activity to allow the tissue time to recover or to use vaginal lubricants to reduce the friction on the tissue. [7]

Recurrent Urinary Tract Infections 

The last possibility worth mentioning is the one I previously eluded to at the beginning of this article. Urinary tract infections are the most frequent cause of dysuric symptoms in the female population. There are two anatomical faults that predispose women to have more urinary tract infections compared to males:

  • First of all, women are more likely to have constant burning after urination because they have much shorter urethras compared to males. Bacteria can easily climb into the urinary tract and migrate into the hospitable bladder in women much more frequently than males as a result. 
  • Another reason that women are more predisposed to urinary tract infections is due to close proximity of the anal canal to the urinary bladder in the female population. Poor hygiene in women can inadvertently inoculate the urinary canal with bacteria like E. coli. This is considered to be the most common reason for urinary tract infections [8].

Of course, it is impossible to change your anatomy but there are some interventions that women can try in order to reduce their chance of recurrent urinary tract infections. When using the bathroom, make sure you are only wiping from the "forward to backward" direction. This will be an easy way to prevent fecal matter from coming in contact with the bladder channel. Drinking cranberry juice is another proven method to help prevent recurrent UTIs [9]. 

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