Matthew Wosnitzer, MD, is a board-certified urologic surgeon and physician scientist. He specializes in male infertility.

The urethra is the tube that passes from the bladder to the outside of the body. Pain in this body part can be very uncomfortable. People often describe urethral pain as a burning sensation, and urinating can sometimes be excruciating.

Urethral pain can occur in all genders. Common causes include:

In addition, in people with a prostate, prostatitis can result in urethral pain. For those with a vagina, menopause can sometimes lead to vaginal dryness, contributing to urethral pain.

Treatment depends on the specific cause. If an STI is the issue, treating a person's partner or partners is also critical.

This article explains the causes, diagnosis, complications, and treatment of urethral pain.

The urethra is the tube running from the bladder to the outside of the body. Depending on a person's anatomy, there are differences in the structure and function of the urethra. These differences can play a role in the different conditions that lead to urethral pain.

Conditions that irritate the urethra can cause urethral pain. The major causes are discussed below.

Urethritis is a medical term that means "inflammation of the urethra." This inflammation may be caused by:

Possible STIs that can cause urethritis include:

Reactive arthritis (Reiter's syndrome) is another potential cause of urethral pain. Infections of the eyes, urinary tract, and genitals often accompany this type of joint pain and inflammation. These co-infections can include:

Reactive arthritis can be associated with:

UTIs often cause urethral pain, but they are much more common in people with a vagina (due to the short length of the urethra). Up to 60% of those with a vagina will have a UTI during their lifetimes. In addition to urethral pain, people may experience:

Interstitial cystitis is a somewhat poorly understood condition. The severe urethral pain mimics a bad UTI, but urine cultures don't show an infection. It's thought by some to be a systemic (body-wide) condition rather than a localized infection. It is often associated with other conditions such as fibromyalgia.

Anything that blocks the urethra can lead to the buildup of urine. This buildup stretches the tissues, causing significant urethral pain. There are many potential causes of obstruction, including:

Some medications, such as Procardia (nifedipine), can irritate the urethra and cause pain. Radiation therapy may also result in chronic pain (radiation cystitis).

There are some bladder-irritating foods, as well, that may irritate the urethra and cause pain. Common culprits include:

Damage to the urethra can lead to pain. Examples of trauma include:

Some noninfectious skin conditions, when present near the opening of the urethra, may cause pain. A few of these include psoriasis and lichen sclerosis.

As noted, benign prostate hyperplasia can occur in people with a prostate. It can lead to narrowing of the urethra and cause pain.

Other conditions that may result in urethral pain in people with a penis include:

Urethral irritation that leads to pain is common in people with a vagina. This irritation may be due to:

Yeast infections are another common cause. These fungal infections can cause significant discomfort and itching.

Bacterial vaginosis is yet another cause related to the vagina. This infection can be very frustrating due to its often chronic nature. Symptoms include vaginal discharge and a fishy odor.

In those who are menopausal, vaginal atrophy can lead to urethral pain and vaginal pain, and dryness. When severe, the urethra can push out of the urethral opening (urethral prolapse). Vaginal atrophy can also increase the risk of UTIs.

There are many things that can cause urethral pain. These include STIs, UTIs, obstruction, trauma, and skin conditions. Some causes are specific to the anatomy of the prostate and penis or vagina.

Diagnosis of urethritis starts with a careful medical history. Your healthcare provider will ask you about any possible risk factors for STIs, such as a new sexual partner or condomless sex. They will also ask about any urological problems you have had in the past.

Your doctor will then perform a physical exam. They will pay special attention to the presence of urethral discharge, ulcers, and enlarged inguinal lymph nodes (lymph nodes in the groin). Additionally, they may gently "milk" the penis by pulling down the shaft to check for discharge.

Your doctor may also examine other areas, such as the scrotum, cervix, anus, and throat, for signs of inflammation. Depending on the results, they may order further tests or recommend a referral to a urologist.

Lab tests to evaluate urethral pain include a urinalysis. This test looks for:

Screening guidelines for STIs include tests for the major STIs such as gonorrhea and chlamydia. If your doctor suspects a yeast infection, they will also do a KOH prep test. Tests for STIs may involve:

Your doctor may do a urine culture to determine if an infection is present. This test can determine the type of bacteria present and its sensitivity to antibiotics. This knowledge helps determine the specific antibiotic that will be most effective in fighting the infection.

Other lab tests may include:

Imaging tests are typically not used to evaluate urethritis. However, it may be necessary if your doctor suspects a kidney infection (pyelonephritis) or kidney stones, or if there is a significant amount of blood in the urine.

More often, imaging tests look for complications of STIs, such as an abscess in an ovary or a fallopian tube.

A cystoscopy is a test that involves inserting a narrow lighted tube into the urethra and bladder. It may be done to:

Sometimes, if there is scarring and strictures, your doctor may need to dilate (open) the urethra to relieve symptoms.

If your doctor suspects that a mass is causing a urethral obstruction, they may order a pelvic computed tomography (CT) scan to get a better look.

In addition to the conditions noted above, several medical conditions may lead to urethral pain. These include:

Diagnosis may include a physical exam, labs, and imaging. Less likely, procedures such as dilation or cystoscopy may be used to open and look inside the urethra.

Some complications may occur with the common causes of urethral pain. These complications make a proper diagnosis essential. Complications include:

In addition, even atrophic vaginitis (vaginal dryness related to menopause) can lead to complications, increasing the risk of urinary tract infections and contracting STIs.

The treatment of urethral pain depends on the underlying cause. Common treatments include:

Fortunately, there are simple measures you can take to prevent the more common causes of urethral pain. Safer sex practices can help reduce your risk of STIs. You can make sex safer by:

Tips for reducing the risk of urinary tract infections include:

It is never normal to have pain in the urethra. So a healthcare provider should always evaluate this symptom unless it has a clear, reversible cause, such as stinging immediately after using a new personal care product. That said, some conditions are more urgent than others.

You should see your healthcare provider right away if you have:

Even if your symptoms are mild or come and go, it's still essential to make an appointment.

Untreated infections with chlamydia and gonorrhea can permanently damage reproductive organs. Even in the absence of symptoms, this can lead to long-term complications.

Urethral pain may be caused by many things, including STIs, trauma, bacterial or fungal infections, and obstruction. To accurately diagnose what is causing pain in your urethra, your doctor will do a physical exam. They may also order labs and imaging tests.

Treatment depends on the cause and may include antibiotics, antiparasitics, antivirals, or symptom management. Urethra pain is never normal. If you have pain in your urethra, be sure to see your doctor.

Because a sexually transmitted infection may be one cause of urethral pain, people are sometimes hesitant to talk to their healthcare provider about it. However, STIs are common and nothing that should cause embarrassment. Additionally, there are many potential causes of urethral pain.

Pain, in general, is your body's way of letting you know that something is wrong. In fact, with urethral pain, listening to your body may not only help you get relief from the pain but may also prevent or reduce the risk of complications related to many of the causes.

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