Have you ever felt pain while urinating (peeing)? If so, then you know how this type of pain can make simple trips to the bathroom very stressful. In addition to physical discomfort, you may have also had anxiety about what was causing your pain.

Painful urination is a symptom that can be caused by many different health conditions, including bladder cancer. Here’s a closer look at painful urination, including its connection to bladder cancer as well as its other possible causes.

What Is Painful Urination, or Dysuria?

The medical term “dysuria” refers to painful or uncomfortable urination. It’s a symptom of a condition rather than a condition itself. The kind of discomfort can vary from person to person, but it’s often described as a burning pain. You may feel pain when you begin peeing, during, or after you’ve stopped. When you notice pain, it can be a helpful clue as to what’s causing your discomfort.

Though most people who experience dysuria describe the type of pain similarly, dysuria may show up differently in women and men. Women may have discomfort either inside or outside of the vaginal area. Men may have lingering pain in the penis before or after they pee.

In general, women tend to have dysuria more often than men. However, having a bladder condition or diabetes or being pregnant can all increase your risk of painful urination.

Painful Urination and Bladder Cancer

Bladder cancer is a possible cause of dysuria. However, feeling pain or discomfort while you urinate often points to another condition other than bladder cancer. Common bladder cancer symptoms include:

• Hematuria (bloody urine that may be the color of cola or bright red)
• Frequent urination
• Back pain

Other possible symptoms of bladder cancer include:

• An urge to pee that’s stronger than usual
• Urinary hesitancy (trouble starting your urine stream)
• Pain in your back between the lower ribs and hip (flank)
• Frequent infections of the urinary tract
• Lower abdominal pain or pelvic pain

Having these symptoms doesn’t mean you have bladder cancer, as they may also be caused by other conditions. However, there are certain risk factors that may make you more likely to develop bladder cancer, including:

• Being older than 55
• Being male
• Smoking or being exposed to other types of harmful chemicals like benzene
• Experiencing chronic inflammation of the bladder from frequent infections
• Having bladder cancer in the past
• Having a relative with bladder cancer or Lynch syndrome
• Receiving past cancer treatment with cyclophosphamide

Talk to your doctor if you notice any pain or discomfort when passing urine or develop any other symptoms of bladder cancer.

Other Causes of Painful Urination

Bladder cancer is only one of several possible causes of painful urination. Many times this uncomfortable symptom is due to another health condition. Certain causes of dysuria are more common in women, while others are more common in men.

Urinary Tract Infections

One of the most common causes of painful urination is urinary tract infections (UTIs). According to Cleveland Clinic, around 50 percent of females will have a UTI at least once.

These types of infection can be caused by different kinds of bacteria, but E. coli is most often the culprit. UTIs may involve any part of your urinary system — the body parts involved in making and storing urine. Lower UTIs occur in the urethra or bladder, while upper UTIs affect the kidneys.

Like bladder cancer, UTIs can cause painful urination, the urge to pee frequently, blood in the urine, and lower back pain. Other signs and symptoms of a UTI may include:

• Urinary incontinence (leaking urine)
• Urine that appears cloudy or is foul-smelling
• Pressure or pain in the lower pelvis
• Abdominal pain
• Fatigue (extreme tiredness that doesn’t improve with rest)
• Fever

Vaginal Infection

Another common cause of painful urination is vaginal infection (vaginitis). This condition can be caused by a bacterial infection or by an imbalance of good and bad bacteria within the vagina. In addition, low estrogen levels, such as after menopause, or certain skin conditions may also result in vaginitis.

The most common types are yeast infections, bacterial vaginosis, and trichomoniasis. In addition to painful urination, symptoms may include:

• Itching or irritation of the vagina
• Pain during sexual intercourse
• Spotting or light vaginal bleeding
• Changes in vaginal discharge, such as color, smell, or amount

Sexually Transmitted Infections

Among males, STIs are the most common cause of inflammation in the urethra — the tube that expels urine from the bladder — according to StatPearls. Gonorrhea and chlamydia are the STIs most often linked to urethritis (inflammation of the urethra).

Symptoms vary depending on the type of STI but may include:

• Painful urination or sex
• Frequent urination
• Discharge from the penis or vagina that may have a foul smell
• Itchiness or swelling near the penis or vagina
• Vaginal bleeding
• Sores, warts, or bumps around or on the vagina, penis, anus, or mouth

Prostate Disease

Another potential cause of painful urination is prostate disease. The prostate is the gland in the male reproductive system that helps make semen. There are several types of prostate disease, including prostatitis (inflammation of the prostate), enlarged prostate (also called benign prostatic hyperplasia, or BPH), and prostate cancer.

Symptoms of prostate disease vary by type but may include:

• Extreme pain or discomfort in the penis, scrotum, perineum (between the scrotum and anus), or belly while urinating or after ejaculation
• Bloody pee
• Frequent urination
• Inability to urinate or only producing a weak urine stream
• Urinary incontinence

You may be more likely to get prostatitis if you have a lower UTI, a lot of emotional stress, or nerve damage in your lower urinary tract, such as from surgery. Risk factors for developing an enlarged prostate include being over 40, having a family history of BPH, and having certain health conditions, such as obesity. The risk of prostate cancer is higher in people who are over 50, are African American, or have a family history of prostate cancer.

Kidney Stones

Kidney stones — hardened mineral and salt deposits — are another potential cause of dysuria. When urine is too concentrated, the minerals inside crystallize and stick together. Kidney stones can impact all parts of the urinary tract.

It can be very painful if kidney stones get stuck in the ureters (tubes between the kidneys and bladder). Symptoms of a lodged kidney stone include:

• Painful urination
• Sharp, extreme pain below the ribs in the back and side
• Pain that changes location and intensity
• Pain in the groin and lower abdomen

Risk factors for kidney stones include being dehydrated, having a family history of kidney stones, having certain medical conditions such as obesity, eating a diet high in sodium, and taking certain supplements. Certain urinary tract infections can also increase the risk. Having a personal history of kidney stones also increases the risk of having another kidney stone in the future.

How Is Bladder Cancer Diagnosed?

If you have symptoms of bladder cancer, your healthcare provider will likely refer you to a urologist. Your urology provider can perform tests to determine the cause of your symptoms. Testing for bladder cancer may include:

• Urine cytology — A urine test where a microscope is used to look for cancer cells within a urine sample
• Cystoscopy — A procedure in which a cytoscope (a small tube with a lens) is inserted into the urethra to check the urethra and bladder for disease. A biopsy (tissue sample) may be collected to test for abnormal cells — a process also known as transurethral resection of bladder tumor (TURBT), which can also remove the entire tumor in earlier bladder cancer stages.
• CT urogram — An imaging test of the urinary tract where a specific dye is injected into a vein. X-ray images are taken as the contrast dye travels into the different parts of the urinary tract to assess for disease.
• Retrograde pyelogram — A procedure to evaluate the upper parts of the urinary tract. A catheter (thin tube) is inserted through the urethra, contrast dye is injected into the ureters, and X-ray images are taken as the dye travels to the kidneys.

If testing confirms bladder cancer, you will be referred to an oncologist. Your oncology provider will likely suggest more imaging tests to check for metastasis (spread of cancer to the lymph nodes or other parts of your body). Tests may include CT scan, MRI, chest X-ray, positron emission tomography scan, or bone scan.

A bladder cancer diagnosis is very treatable when the cancer is found at an early stage. This is why it’s so important to see your doctor as soon as you notice painful urination or any other symptom of bladder cancer.

Bladder cancer treatment depends on your type of cancer, its severity, and your overall health. Treatment options include surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Talk With Others Who Understand

MyBladderCancerTeam is the social network for people with bladder cancer and their loved ones. On MyBladderCancerTeam, members come together to ask questions, give advice, and share their stories with others who understand life with bladder cancer.

Did you have painful urination as a symptom of bladder cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.