Urology / Nephrology

Abdominal pain and painful urination causes

Experiencing both abdominal pain and painful urination can be concerning. Common issues, such as urinary tract infections, can cause these symptoms. Less often, a more serious condition is responsible.

The cause of abdominal pain can be difficult to isolate, as the abdomen houses most of the vital organs. Often, issues such as inflammation or infection cause pain in the area.

The diagnosis of pain while urinating is usually more straightforward, as the cause usually lies somewhere in the urinary tract.

In any case, it is essential to identify the cause of these types of pain.

Causes in females

Potential causes in females may include:

Cystitis

Woman on the toilet with abdominal pain and painful urination
Causes of abdominal pain and painful urination can include cystitis and pelvic inflammatory disease.

A person with a bladder infection, or cystitis, may experience pain in the lower abdomen and a burning sensation while urinating.

Some other signs of a bladder infection include the following:

  • a frequent, urgent need to urinate
  • frequent urination at night
  • foul-smelling urine
  • urine that contains blood

Bacteria most commonly cause these infections, and doctors often recommend antibiotics. Treatment is crucial to keep the infection from spreading.

Interstitial cystitis

Interstitial cystitis causes bladder irritation and inflammation, and it is more common in females.

This condition stiffens the lining of the bladder. As the bladder fills with urine, the stiffness can lead to pain, which later eases.

Interstitial cystitis can also cause urinary tract issues such as needing to urinate frequently but only passing small amounts.

The underlying cause of interstitial cystitis is unclear. Treatment often begins with managing symptoms, and practicing pelvic floor exercises and stress management techniques may help.

Pelvic inflammatory disease (PID)

PID results from an infection somewhere in the female reproductive organs, including the:

  • uterus
  • ovaries
  • cervix
  • fallopian tubes

The United States Department of Health and Human Services estimate that PID affects around 5 percent of females in the country.

Other symptoms may include painful sex, foul-smelling vaginal discharge, or irregular periods.

Bacteria from sexually transmitted infections (STIs), such as gonorrhea and chlamydia, typically cause PID.

Treatment includes antibiotics. Most cases resolve with oral antibiotics, but severe cases may require hospitalization and intravenous antibiotics.

Endometrial cancer

While less common than other causes, endometrial cancer can lead to pain in the abdomen and while urinating.

The endometrium is the lining of the uterus. Cancerous tissues in this lining can cause symptoms such as pain and inflammation.

Treatments may include radiation or chemotherapy, and some people have a partial or total hysterectomy to remove the cancerous tissue.

Causes in males

Potential causes in males may include:

Prostatitis

Man walking to the toilet at night due to abdominal pain and painful urination
Causes in males can include prostatitis and epididymitis.

Inflammation in the prostate, or prostatitis, may cause painful urination and pain in the lower abdomen.

The inflammation may spread to areas around the prostate and cause other symptoms, such as:

  • lower back pain
  • a fever
  • difficulty starting urination
  • difficulty maintaining the urine stream

Treatment depends on the underlying cause.

Sometimes, prostatitis requires no treatment and clears up on its own. In other cases, the inflammation results from a bacterial infection, which a doctor can treat with antibiotics.

If a doctor cannot initially identify the cause of the inflammation, they will find ways to relieve symptoms while working to diagnose the underlying issue.

Epididymitis

The epididymis is the tube behind the testicles that carries sperm to the urethra. Inflammation of the epididymis can result from issues such as infection or injury.

Symptoms may include:

  • pain or swelling in the testicles
  • pain or swelling in the pelvis
  • pain during sexual activity
  • tenderness of the penis
  • strange discharge from the penis

Treatment typically includes antibiotics, to clear up an underlying infection, and medications for pain and inflammation.

Causes in males and females

Potential causes in both males and females include:

Urinary tract infection (UTI)

UTIs affect males and females, though they are more common in females.

These infections most frequently arise in the bladder, but they can occur in any part of the urinary tract, including the:

  • kidneys
  • ureters
  • urethra

Females often experience pain in the pelvis, while males typically experience pain in the rectum. Other symptoms may include a more intense urge to urinate and changes in the look or smell of the urine.

Bacteria are typically responsible for the infection, and treatment generally involves antibiotics.

STIs

Sexually active people may be at risk of contracting infections such as gonorrhea and chlamydia. These can cause a burning sensation while urinating and pain in the lower abdomen, among other symptoms.

Some people also experience discharge from the urethra, though STIs often cause few visible symptoms.

Genital herpes

This STI also causes painful blisters that ooze fluid then scab over. Many people feel the associated pain even before the blisters appear.

There is no cure for herpes, so treatment focuses on reducing outbreaks.

Kidney stones

Stones made up of excess minerals can cause pain as the body tries to pass them through the urinary tract.

The pain may be intense, especially while urinating. In some cases, a stone can block off the urine stream completely.

Treatment depends on the size and mineral content of the stones. Some medications can help break them up, making them easier to pass, while others can relieve the pain.

Urethral stricture

A urethral stricture occurs when the opening of the urethra narrows and restricts the flow of urine. It can cause pain in the abdomen and pain during urination.

The narrowing usually results from inflammation or scar tissue in the area. This scar tissue may form after injury, surgery, or using medical devices such as catheters.

A doctor may try to dilate the urethra as an initial treatment. Some cases of stricture require surgery to widen the urethra.

Bladder cancer

Though not as likely as many other causes, bladder cancer can result in abdominal pain and pain during urination.

Bladder cancer can develop in males and females, but it is much more common in males.

The American Cancer Society estimate that in 2018 there were 81,190 new bladder cancer cases in the U.S. Approximately 62,380 of these cases occurred in males.

Other symptoms include:

  • lower back pain
  • a frequent need to urinate
  • difficulty urinating or maintaining a steady stream
  • blood in the urine

Treatment varies, but it typically involves removing the cancerous cells and managing symptoms.

When to see a doctor

doctor discussing with a pregnant lady
A person who is pregnant and has pain in the abdomen alongside pain while urinating should see a doctor right away.

Pain in the abdomen and pain while urinating may be alarming, but if the symptoms are mild, a person can often wait a few days before seeing a doctor.

However, people who are pregnant or who have immune system disorders should see a doctor right away.

Also, people who know that they have urinary tract issues or who tend to experience these types of symptoms frequently should likewise seek medical attention without delay.

Additional issues that can indicate an underlying problem include:

  • pain in the sides or the back near the kidneys
  • a fever or chills
  • immune system disorders
  • using a urinary tract device, such as a catheter

Prevention

It may not be possible to prevent painful urination or abdominal pain, but certain measures may help.

Staying hydrated helps the body clean the urinary tract and flush out toxins from the body.

Washing the hands before touching the genitals and regularly washing the genitals with a mild soap may help avoid irritation or infection.

Females should wipe from front to back to prevent the spread of bacteria. Refraining from using harmful chemicals near the urethra or genitals may also help.

Engaging in sexual contact only with partners who have bathed recently may prevent some health issues. Also, using protection during intercourse can help prevent STIs.

Takeaway

Abdominal pain and painful urination can cause concern, and it is important to seek a diagnosis and treatment if the symptoms become worse or do not go away within a few days.

Receiving prompt treatment may help prevent complications, and it can often relieve the pain.

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