Painful urination is not a disease in itself, but reflects underlying medical problems, including urinary tract infections, urinary stones, enlarged prostate, prostatitis, sexually transmitted diseases, vaginal infections (bacterial or fungal) and other gynecological conditions, sometimes caused by lack of hygiene or dehydration. This symptom is common in people aged 18-50, more often in women, and is mostly caused by acute cystitis, while in men it is mostly caused by UTI or prostate problems. Painful urination can stand alone, occurring during or after urination, or it can be accompanied by other symptoms such as the urge to urinate, frequency, urgency, inability to urinate, or even discomfort in the lower abdomen or lower back perineum. If the urinary pain originates from the urethra (the tube through which urine exits the body from the bladder), it is necessary to know a little bit about the anatomy. The urethra is somewhat different in adult males and females, being longer in males, over 20 centimeters, and shorter and wider in females, 4-5 centimeters long. The urethra is a tubular organ that transports urine and is covered with a urinary epithelium that can be rapidly renewed. The kidneys filter the blood to form urine and pass it out of the body through the final urethra. Urine contains a much higher concentration of salts (electrolytes) and metabolites (waste products) than body fluids, such as blood, tissue fluids, and intracellular fluids. Sometimes we see patients with urostomies where urine impregnation can even damage the skin around the stoma, indicating that it is highly erosive. The cells on the surface of the urethra are not able to resist the direct contact of urine, so in the interstices of the mucosal cells more glands will secrete mucus, forming a thin protective layer of mucus on the surface of the mucous membrane, so that the urine and the mucous membrane do not come into direct contact with each other. The glands here are similar to other hollow organs in the body, a kind of small mouth and big belly, similar to a tall flask structure. This structure facilitates the production of mucus and storage to a certain amount and then slowly excreted, but the disadvantage is that the opening is easily blocked, the internal fluid drainage is blocked and then stagnant, and then secondary infection. It is the same thing as a pimple on the face! Western medicine is like this, explain the anatomical basis will be good to further analyze. Simply from the length of the female urethra, the depth of protection is much less than men. There are statistics that in childhood, boys and girls have about the same chance of urinary tract infections, and after sexual maturity the incidence of women is all of a sudden higher than that of men, indicating that sexuality is also one of the triggers that lead to urinary tract infections in women. Under the dual mechanism, external germs can easily enter the urethra and bladder retrogradely. Germs rarely stay in the short urethra and enter the bladder, triggering a reaction that can be more dramatic, hence the higher incidence of acute cystitis in women. Female Urethra and Para-Urethral Glands If mucus is being produced, why don’t we usually notice it? This is because this layer of fluid is not very large and is flushed out by the urine during urination. Urethral discharge occurs only when the glands are overproducing and it is too late to be flushed out, which is manifested as white dots on the underwear (small amount) or pus-like material (large amount). When do I overproduce? When it is infected or inflamed! The male urethra is long, so germs can’t easily backflow long distances into the bladder, and the glands that line the urethra can become blocked from time to time, so problems with the urethra are far more common than with the bladder. Male Urethra and Para-Urethral Glands Urinary tract infections in women are rarely in the urethra alone, so painful urination is often accompanied by bladder irritation, i.e., urgency, frequency, or even hematuria. In non-complicated cases, a simple routine urinalysis can be definitive. Treatment with oral antibiotics for a week or so is sufficient, just be careful to recheck once to ensure cure. In men, the situation is a bit more varied, and many are simply painful urination with or without urethral discharge. As mentioned earlier, the mechanism of occurrence can be either self-obstruction (non-infectious) or exogenous invasion (infectious), with the latter mostly due to sexual contact. Most of the patients contacted in the outpatient clinic had painful urination alone or with varying degrees of urinary tract irritation, and there was no history of untoward sexual contact. By taking a careful history followed by physical examination, there is tenderness in the urethra, especially at or near the opening, discharge is often unremarkable, and the urine routine is negative. At this point, the diagnosis is mostly non-specific urethritis, that is, a small number of local glandular obstruction caused by inflammation, the measures taken are warm water immersion (physiotherapy) and local self-massage (physical compression), while drinking more water to dilute the urine to reduce the high concentration of irritation, which can be relieved in a very short period of time. There is no need for medication in this case, and infusion is even less necessary. Uneasy? Think about it, would you take medicine for a small boil? Massage can squeeze out the blocked infected material, achieving the same effect as squeezing a pimple and promoting the inflammation to subside. Another scenario: there is no history of adverse sexual contact, there is a discharge whose tenderness is more extensive, and a positive urinalysis, indicating a higher number of inflamed glands. In addition to some of the physical methods mentioned above, men should see a doctor at this time and take antibiotics appropriately under the guidance. And review is necessary! If not properly controlled in time, chronic prolongation may lead to urethral strictures and other problems that require surgery to treat. So where did the germs come from? Your wife is not a sterile body, there are many colonies of bacteria in the vagina (lactobacilli are predominant in normal times, but there are many more species in the case of an attack), your honey, and your husband’s urethral poison. And some chemicals, such as bath bombs, soaps, topical contraceptives, spermicides in condoms, gynecological lotions, and so on, can trigger a sterile inflammatory response. As a spouse, you also have a responsibility drop for your man’s brother! If you have discomfort, such as cystitis, vaginitis manifestation, to inform the man, at the same time their own active treatment. Then there is a man who is not protected intercourse, after the pain of urine and discharge, typical sexually transmitted urethritis. The pathogenic bacteria that cause this kind of disease are relatively fragile, timely medical treatment and antibiotic treatment is very easy to get cured, gonorrhea is an example, the correct face and treatment is very easy to get well. Avoid sex or protected intercourse during treatment to avoid infecting others. What is more dangerous is not dare to seek medical treatment and superstitious poles or nymphomaniac small ads, run to some unknown ghost place was a mess, spend money but not cured, but also infected to other people. If you have had sex with your spouse during the period, the woman may have symptoms or hidden infection without symptoms. The most suitable location for women to accommodate germs is the vagina, and vaginal medication is preferred, while if there is a combination of urinary tract problems at the same time it is treated as a urinary tract infection. In conclusion, painful urination is a symptom of the urinary tract that interferes with our lives from time to time, with different backgrounds and causes in men and women. The urethra is no different from any other organ in the body, and the occasional cold or infection is something that you sometimes know better than your doctor. However, in some cases, because doctors are not well-trained, do not pay enough attention to it, or the patient can hide the condition, it is simply attributed to an infection or prostatitis, etc., which is ineffective and can lead to hidden problems.