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Dysuria in Men

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  1. See Also
    1. Dysuria
    2. Dysuria in Women
  2. Causes
    1. Infection
      1. Urinary Tract Infection
        1. Pyelonephritis (Enterobacteriaceae)
        2. Acute Cystitis (Enterobacteriaceae)
      2. Urethritis (Gonorrhea and Chlamydia)
      3. Prostatitis (Enterobacteriaceae)
      4. Epididymitis and Orchitis (Enterobacteriaceae, Mumps)
      5. Meatitis and Urethritis (HSV II infection)
      6. Balanitis
    2. Obstructive Uropathy
      1. Benign Prostatic Hypertrophy
        1. May also predispose to Urinary Tract Infection
      2. Urethral stricture
        1. Urethral instrumentation
        2. Prior Gonorrhea infection
    3. Miscellaneous Causes
      1. Prostadynia
    4. Non-gender specific causes
      1. See Dysuria
  3. Symptoms and Signs
    1. See related conditions
      1. Urinary Tract Infection
      2. Prostatitis
      3. Epididymitis
    2. Penile discharge suggests urethritis (STD)
      1. Gonorrhea
      2. Chlamydia
    3. Penile lesion present
      1. Vesicles: Genital Herpes
      2. Ulcer: See Genital Ulcer
      3. Glans irritation: Balanitis
    4. Scrotal Pain
      1. Epididymitis
      2. Orchitis
    5. Perineal or Rectal Pain or prostate pain on palpation
      1. Prostatitis
      2. Prostadynia
  4. Evaluation
    1. Labs in all patients
      1. Urinalysis with microscopy
      2. Urine Culture
    2. Sexually active patient
      1. Routine swab for Gonorrhea and Chlamydia
      2. Urethral discharge
        1. Urethral smear for diplococci (Gonococcus)
        2. Urethral culture
    3. Symptoms of Prostatitis
      1. Consider Expressed Prostatic Secretion exam
      2. Do not perform Prostatic Massage in Acute Prostatitis
  5. References
    1. Kurowski (1998) Am Fam Physician 57(9):2155
    2. Roberts (1999) Am Fam Physician 60(3):865

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