Urethral Pain & Urethritis Causes

If you’re struggling with urethral syndrome or urethritis, it’s not always the result of infection. From hormones to chemicals and, perhaps even an infection of a gland, you’ll need to rule out each of these potential causes for urethral discomfort.

1. Catheterization & Procedures

Each time you are catheterized, undergo a bladder examination or have a bladder treatment, the urethra is mildly traumatized. This can cause sharp and stabbing pain in the urethra during the first few voids afterwards. Ideally, your physician is already using some lidocaine gel and smaller, less traumatic catheters (i.e. hydrophilic) but, even then, urethral discomfort is inevitable and every patient eventually learns how to cope with it. The good news is that this kind of urethral irritation generally improves with each void until, 24 to 48 hours later, it has resolved completely

2. Bladder Infection

If you’re like many patients, you may have spent months or years thinking that your symptoms were the result of a bladder infection. If your urethra hurts while you are peeing, test your urine with an AZO Bladder Test strip. If it’s positive for nitrates, call your urologist and ask for a urine culture so that they can identify the bacteria involved and, most importantly, determine which antibiotic will best kill that specific infection. If it’s negative for nitrates, then other causes listed should be explored.

3. Hormones

If urethral discomfort is chronic, women must also consider the overall health and integrity of your skin. Estrogen atrophy could be driving your symptoms. Estrogen helps make your mucus membranes thick, moist and resilient. When you lose estrogen from using birth control, lupron or during perimenopause, your skin “down there” can become drier and much more sensitive, particularly the bottom half of the urethra. Ask your physician to look at your vulva. If it is showing signs of dryness or thinning, they may suggest a topical, preservative free estrogen cream to help strengthen, restore and maintain skin health. Using a light, oil based gel, such as VulvaBalm, can also reduce pain caused by dryness and protect the skin from the irritating effects of urine.

4.Pelvic Floor Tension

Consider, as well, the role of muscles in urethral pain. The pelvic floor muscles wrap around the urethra, vagina and rectum as they support the pelvic organs. If you’re tense, these muscles become tight thus making it harder to void, have a bowel movement or enjoy intimacy. Patients with urethral syndrome may have involuntary spasms and tightening of the pelvic floor muscles during painful flares which triggers chronic pelvic floor muscle dysfunction.

Every patient (men and women) should request a pelvic floor assessment to determine if the pelvic floor muscles are contributing to your pain and discomfort, especially if you are having difficulty with intimacy and sexual intercourse. PFD is very treatable using pelvic floor physical therapy. Breaking Through Chronic PelvicPain by Dr. Jerome Weiss) and Ic101: It’s Not Just a Bladder Disease are two books that can help you understand the role of the pelvic floor in causing pain and discomfort as well as a variety of exercises and stretches to reduce muscle tension.

5. Chemical irritation

Never underestimate the role of chemicals in causing urethral discomfort. Some men and women are very sensitive to spermicides or latex condoms while others react badly to something as simple as soap, bubble bath, toilet wipes or fabric softener. Chemicals can irritate the skin and our super sensitive nervous system. If you struggle with any skin or urethral sensitivity, you should not be using bath salts or bubble baths. BASIS for Sensitive Skin is a hypoallergenic soap ideal for anyone with sensitivity “down there”. For laundry detergent, try using the very mild baby detergent, DREFT, and always rinse your underwear twice to remove any residual detergent or fragrances. Do not use any extra rinses or fabric softeners. Even the chlorine in swimming pools and hot tubs can provoke urethral irritation. Try different spermicidal products or, perhaps, latex free condoms as well.

6. Off Gassing From Pads and Pantiliners

Contrary to the ads from feminine hygiene companies, dryness is not the natural state of the skin in the crotch. For women, the surface of the vulva, vagina and bladder is supposed to be moist and covered with mucus which provides essential protection for the more sensitive skin cells beneath. Wearing pantiliners or pads everyday can remove some of this mucus and make your skin more tender. Worse, though, are some of the chemicals used in pads for absorption and odor removal. When these become wet, they can “off gas” chemicals which can irritate your skin. A diehard ALWAYS customer, I cannot wear the new ALWAYS INFINITY pads because they make my vulva burn due, I believe, to these extra chemicals. So, if you don’t need to wear pad, don’t. But if you do, try using chlorine free pads, such as the CORA Organics line of pads.

7. Infection of the Prostate / Paraurethral / Skene’s Glands

Men and women have glands near the urethra that can become infected and irritated. For men, it’s the prostate gland at the base of the penis. For women, it’s the paraurethral or skene’s gland located halfway up the urethra and, you might be surprised to learn, are the female equivalent of the male prostate. Both the prostate and the paraurethral glands are like sea sponges, very dense tissue with small drainage ducts that can easily become blocked thus allowing bacteria to flourish inside. In men, an infected prostate often swells into the urethra where it can block the flow of urine and make it difficult to urinate. In women, an infected skene’s gland is more like a hard, deep painful pimple that hurts with touch or pressure. Women can often feel an infected gland if they stick their finger (washed, of course) up into the entrance of the vagina.. about an inch or two.. and rub gently along the front side of the vagina. It often has the consistency of a small, firm and painful pea. If you have an infection of any gland, doctors may need to drain it and/or express the fluid/pus to get it to calm it down. Please talk with your doctor about the various treatment options available.