The causes of prolonged painful urination in elderly women are considered to be the decline of the defense ability of the urethral mucosa with age, urine residue in the bladder, hardening of the bladder neck and uterine prolapse leading to poor urination, decreased immunity, and incomplete treatment. 1. Decline in defense of urethral mucosa: Due to ageing, the urethral mucosa of elderly women has degenerative changes, and the resistance to external invasive bacteria and other pathogenic microorganisms decreases, which in turn makes it easier to develop urinary tract infections and symptoms of painful urination. 2. Urine residue in the bladder: with age, the patient’s bladder contractility decreases, it is not easy to urinate thoroughly, which leads to urine residue in the bladder, more likely to lead to bacterial infections, urinary pain. 3. Poor urination: mainly related to elderly women with bladder neck sclerosis and uterine prolapse, lesions on the urethra caused by compression, urinary reflux can occur during urination, increasing the chance of urinary tract infection. 4. Decline in immunity: with age, especially the presence of diabetes and other chronic diseases, leading to a decline in resistance, patients are more prone to invasion of bacteria and other pathogenic microorganisms. To summarize, it is recommended that patients seek timely medical examination in order to clarify the condition, and professional physicians to give appropriate treatment for the condition.