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Painful Urination

Pain or discomfort while passing urine is usually caused by inflammation of the urinary tract, often due to infection. In women, pain when passing urine may be due to vaginal infection. Discoloured urine sometimes accompanies this type of pain but can occur in the absence of disease (see Checking the appearance of your urine).

  • Do you have either of the following symptoms?

    • Pain in the back just above the waist
      • Possible cause A kidney infection is a possible cause of your symptoms (see Pyelonephritis).

        Medical help URGENT! Phone your doctor immediately!

    • A temperature of 38°C (100.4°F) or above
      • Possible cause A kidney infection is a possible cause of your symptoms (see Pyelonephritis).

        Medical help URGENT! Phone your doctor immediately!

    • Neither

      Have you felt the need to pass urine more frequently than usual?

      • Increased frequency

        Do you have any of the following symptoms?

        • Lower abdominal pain
          • Possible cause A urinary tract infection, such as cystitis, is possible.

            Medical help See your doctor within 24 hours. Meanwhile, follow the self-help advice for cystitis.

        • Blood in the urine
          • Possible cause A urinary tract infection, such as cystitis, is possible.

            Medical help See your doctor within 24 hours. Meanwhile, follow the self-help advice for cystitis.

        • Cloudy urine
          • Possible cause A urinary tract infection, such as cystitis, is possible.

            Medical help See your doctor within 24 hours. Meanwhile, follow the self-help advice for cystitis.

        • None of the above

          Are you female or male?

          • Female

            Have you noticed soreness or itching in the genital area?

            • Soreness

              Do you have an unusual vaginal discharge?

              • Thick, white discharge
                • Possible cause A vaginal yeast infection is the most likely possibility (see Vaginal thrush).

                  Medical help Make an appointment to see your doctor if this is the first time you have had these symptoms. Otherwise, try using an over-the-counter antifungal preparation recommended by your pharmacist.

              • Yellowish-green discharge
                • Possible cause The most likely cause is either a vaginal infection, such as trichomoniasis, or a sexually transmitted infection, such as gonorrhoea.

                  Medical help See your doctor within 24 hours.

              • No unusual discharge
                • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

            • Itching

              Do you have an unusual vaginal discharge?

              • Thick, white discharge
                • Possible cause A vaginal yeast infection is the most likely possibility (see Vaginal thrush).

                  Medical help Make an appointment to see your doctor if this is the first time you have had these symptoms. Otherwise, try using an over-the-counter antifungal preparation recommended by your pharmacist.

              • Yellowish-green discharge
                • Possible cause The most likely cause is either a vaginal infection, such as trichomoniasis, or a sexually transmitted infection, such as gonorrhoea.

                  Medical help See your doctor within 24 hours.

              • No unusual discharge
                • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

            • Neither
              • Possible cause A urinary tract infection, such as cystitis, is possible.

                Medical help See your doctor within 24 hours. Meanwhile, follow the self-help advice for cystitis.

          • Male

            Do you have an unusual discharge from your penis?

            • Discharge
              • Possible cause A sexually transmitted infection, such as gonorrhoea or nongonococcal urethritis, may be causing your symptoms.

                Medical help See your doctor within 24 hours, or go to a clinic specializing in sexually transmitted infections.

            • No discharge
              • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

      • No increased frequency

        Are you female or male?

        • Female

          Have you noticed soreness or itching in the genital area?

          • Soreness

            Do you have an unusual vaginal discharge?

            • Thick, white discharge
              • Possible cause A vaginal yeast infection is the most likely possibility (see Vaginal thrush).

                Medical help Make an appointment to see your doctor if this is the first time you have had these symptoms. Otherwise, try using an over-the-counter antifungal preparation recommended by your pharmacist.

            • Yellowish-green discharge
              • Possible cause The most likely cause is either a vaginal infection, such as trichomoniasis, or a sexually transmitted infection, such as gonorrhoea.

                Medical help See your doctor within 24 hours.

            • No unusual discharge
              • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

          • Itching

            Do you have an unusual vaginal discharge?

            • Thick, white discharge
              • Possible cause A vaginal yeast infection is the most likely possibility (see Vaginal thrush).

                Medical help Make an appointment to see your doctor if this is the first time you have had these symptoms. Otherwise, try using an over-the-counter antifungal preparation recommended by your pharmacist.

            • Yellowish-green discharge
              • Possible cause The most likely cause is either a vaginal infection, such as trichomoniasis, or a sexually transmitted infection, such as gonorrhoea.

                Medical help See your doctor within 24 hours.

            • No unusual discharge
              • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

          • Neither
            • Possible cause A urinary tract infection, such as cystitis, is possible.

              Medical help See your doctor within 24 hours. Meanwhile, follow the self-help advice for cystitis.

        • Male

          Do you have an unusual discharge from your penis?

          • Discharge
            • Possible cause A sexually transmitted infection, such as gonorrhoea or nongonococcal urethritis, may be causing your symptoms.

              Medical help See your doctor within 24 hours, or go to a clinic specializing in sexually transmitted infections.

          • No discharge
            • If you cannot identify a possible cause for your symptoms from this chart, make an appointment to see your doctor.

Checking the appearance of your urine

The appearance of urine varies considerably. For example, urine is often darker in the morning than later in the day. Some drugs and foods may also cause a temporary colour change in the urine. Beetroot, for example, may turn the urine red.

A change in your urine can indicate a disorder. Very dark urine may be a sign of liver disease (see Acute hepatitis); red or cloudy urine may be due to bleeding or infection in the kidney or bladder.

If you are not sure about the cause of a change in the appearance of your urine, consult your doctor.

Normal appearance of urine

Normally, urine is clear, pale, and straw-coloured but may be cloudy at first in the morning.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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