Pain in the urethra


Urethral pain is usually a burning and or pressing feeling of pain. It occurs through irritation, which can have a variety of causes.

Causes in women

In women, the most common cause of urethral pain is a cystitis, which usually includes inflammation of the urethra. The proximity of the urethra to the vagina and rectum makes it very easy for bacteria to get into the urinary bladder. There they can then cause inflammation. This is also favored by the very short urethra of only 3 to 5 cm. The mere anatomy of the woman is thus the strongest risk factor for a cystitis. With frequent sex, this transmission of germs from the rectum area and the vagina to the urethral opening takes place more intensely.

Another cause of a feeling of pain in the urethra can be so-called transurethral urinary catheters, which are pushed through the urethra into the bladder and thus drain the urine over a longer period of time and collect it in a collecting bag at the outer end. On the one hand, the friction of the plastic in the urethra often causes irritation and, on the other hand, an infection can get into the bladder and the ureter via the connection between the urinary bladder and the outside. In both cases there may be pain in the urethra.

Other causes of inflammation and thus pain in this area can be a malformation of the bladder, which allows residual urine to remain in the bladder, and inadequately treated diabetes mellitus. This disease is noticeable by increased sugar concentrations in the blood and urine, in which bacteria particularly like to multiply. In addition, drugs such as cyclophosphamide (used in chemotherapy), aspririne, ibuprofen and diclofenac can cause irritation. Another cause can be urinary bladder stones or cancer that leads to pain in the urethra.

A doctor should find the exact cause, especially if the complaints occur more frequently or do not go away over a long period of time.

Causes in men

Since the man's urethra is approx. 20 cm long and anatomically much further away from the rectum, the mere transmission of germs from the outside into the urinary bladder and the urethra is very rare, but does occur. Just like in women, a so-called transurethral urinary catheter can be a cause of pain in the urethra. This is a plastic tube that is pushed through the urethra into the bladder, drains the urine and collects it at the outer end in a reservoir. This is a benefit for bacterial infections and can also lead to irritation of the urethra.

Another common cause of pain in this area can be a benign prostate enlargement or inflammation of the same. The prostate is often involved in irritation because of its location between the bladder and urethra. As with women, certain medications such as cyclophosphamide (used in chemotherapy), ibuprofen, aspirin and diclofenac can cause painful irritation. In addition, bladder stones or cancer of the bladder and the upstream and downstream urinary tract can lead to pain in the urethra. Therefore, frequent or even permanent urethral pain should be clarified by a doctor.

Please also read our article on this Burning sensation in the urethra.


Urethral pain is usually a symptom of uncomplicated urinary bladder inflammation. In order to obtain a reliable diagnosis for this and also to be able to rule out other diseases, such as complicated urinary bladder inflammation, some examinations help in making the diagnosis.

The most important thing is the anamnesis, i.e. questioning the patient. If, for example, mild symptoms and a rare occurrence are stated, no further examination needs to be carried out. Otherwise, a urine test will be done, paying particular attention to blood, bacteria, and inflammatory cells. Ultrasound of the urinary bladder and kidneys can also be performed.

Concomitant symptoms

Accompanying symptoms of urethral pain, especially with urinary bladder inflammation, can be difficult emptying of the bladder, pain when urinating and a frequent urge to urinate with only small amounts of urine escaping. This can also lead to an unwanted loss of urine due to the irritation. If pain occurs in the lower abdomen and the urine takes on a distinct red color, it can be assumed that there is severe inflammation. If instead or in addition there is fever or pain in the flank region or in the man's scrotum, a doctor should then be consulted for further diagnosis and therapy at the latest. This may involve inflammation of the renal pelvis or, in men, inflammation of the epididymis, which must be treated.

Read more on this topic: Problems urinating

Treatment / therapy

In the case of mild symptoms of pain in the urethra, especially in women, an increased amount of water is often sufficient to flush out the germs. However, if the symptoms are worse, an antibiotic should be prescribed. For this, "Fosfomycin" or "Pivmecillinam", a penicillin-related drug, can primarily be used. If you are pregnant, you have to resort to "cefuroxime", for example. In addition, more complicated inflammations, i. those that have infected other organs such as the kidney pelvis, the prostate or the epididymis, or a man's cystitis are supplied with an antibiotic much more targeted to the identified germs.


The duration of urethral pain depends on the cause. If there is a urinary bladder infection, the duration can vary greatly. Such painful irritation of the bladder and urethra can last from a few hours to several weeks. In most cases, however, it heals completely within a few days. However, if the symptoms persist or even intensify after a few days, it is advisable to consult a doctor quickly. With antibiotic therapy, the symptoms subside significantly within a day and completely disappear in the following days. If this is not the case, the therapy has to be changed, which makes a further visit to the doctor necessary.

Urethral exit pain

These symptoms go hand in hand with the pain in the urethra from irritation, such as frequent cystitis. It is accompanied by inflammation of the urethra and the urethral outlet, as the bacteria first migrated from the outside through the opening of the urethra and then over the entire length of the urethra into the urinary bladder itself. This is particularly easy in women due to their anatomical proximity to the urethra and its opening with the area of ​​the rectum and vagina. However, if the man complains of pain at the urethral outlet, other inflammation sites must also be considered, such as the tip of the penis itself. Since we have particularly many nerve endings at the urethral opening, we perceive the greatest pain in the entire urethra as being there.

Urethral pain when urinating or ejaculating

Often urethral pain is aggravated by urination when the urinary bladder and urethra are inflamed. The urine irritates the inflamed mucous membrane of the urethra, which we can perceive particularly strongly at its opening, as there are many nerve endings there. The same painful irritation of the inflamed mucous membrane can be caused in a man by ejaculation. In addition to the fact that such complaints in men should always be examined, a doctor must rule out that the inflammation has not reached the prostate and / or the epididymis.

Read more on this topic: Painful urination

Urethral pain when sitting

If pain occurs in the urethra or in the pelvis, especially when sitting, then an inflammation of the prostate should be considered in men. It sits below the bladder on the urethra and can therefore be easily pressed while sitting. In addition, a pressing pain when sitting can also occur with a benign prostate enlargement. Sitting on a narrow bicycle seat is perceived as particularly uncomfortable. Since inflammation of the prostate must be treated with medication, the patient should consult a doctor with these pain symptoms.

In women, pain that increases significantly when sitting can be associated with irritation of the uterus, vagina or ovaries. In addition to inflammation, the cause can also be menstrual bleeding, which is often associated with a feeling of pressure. If the symptoms persist for a long time, a gynecologist should examine all organs involved more closely.