Dysuria R30.0

Dysuria is a weakened urinary stream.

In most cases, the symptoms are associated with alguria (pain and burning sensation when urinating) and/or stranguria (painful tenesmus during micturition). The term "dysuria" is often used as a collective term including alguria and stranguria.

The dysuria is gender-specific. In almost 50% of all women, the symptoms occur once or several times in the course of life, and in about 20% even within the last year.

Dysuria is much less common in men.

The weakened urinary stream is caused by difficult urination due to bladder emptying disorders.

In women, the following conditions predominantly cause dysuria:

• Urinary tract infections
• Inflammations of the lower genital tract

In men increasingly due to

• Changes in the prostate (enlargement, inflammation etc.)

Other causes occur independently of sex:

• Tumors of the bladder and / or urethra
• Urolithiasis
• Behcet's syndrome
• Reactive arthritis (often as an early symptom)
• Chronic urethral syndrome

The patient complains of frequent and painful urination. The urge to urinate is increased.

Pain at the beginning of micturition indicates urethral etiology, while pain at the end of micturition is more indicative of a disease of the bladder.

Both micturition time and urinary flow rate are increased.

Since in most cases an inflammation of the bladder is the cause in women, a urine examination should be performed first, and in men a rectal examination of the prostate.

Further diagnostics according to the differential diagnoses.

According to the underlying disease

1. Braun J et al. (2009) Clinical Guide to Internal Medicine S 393

2. Herold G et al (2018) Internal Medicine S 600

3. Kasper DL et al (2016) Harrison's Principles of Internal Medicine 19th Edition 60 E1

4. Manski D (2018) Urology textbook. S53-62

5. Villinger PM et al (2006) Rheumatology in brief S. 2