Urinary Tract Infection (UTI): This is the most common cause of painful urination, especially in women. The presence of dysuria (painful urination), frequency, and urgency, along with a positive urine culture, supports this diagnosis.

Kidney Stones: Small stones in the urinary tract can cause severe pain, especially if they are moving down the ureter. The pain is often colicky and radiates to the groin.
Prostatitis: Inflammation of the prostate gland can cause painful urination in men, along with other symptoms like pelvic pain and difficulty starting urination.
Urethritis: Inflammation of the urethra, often due to infection, can cause painful urination, especially in men.
Vaginitis: Infections or inflammation of the vagina can cause painful urination in women, especially if the urethra is irritated.

Gonorrhea or Chlamydia: These sexually transmitted infections can cause painful urination and, if left untreated, can lead to serious complications like infertility and pelvic inflammatory disease.
Tuberculosis of the Urinary Tract: Although rare, TB can infect the urinary tract and cause painful urination, along with other symptoms like hematuria (blood in the urine) and weight loss.
Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can be mistaken for a UTI but requires different management.

Bladder Cancer: Although rare, bladder cancer can cause painful urination, especially if the tumor is large or obstructing the flow of urine.
Schistosomiasis: A parasitic infection that can cause urinary symptoms, including painful urination, in people who have traveled to or lived in areas where the parasite is common.
Urethral Stricture: A narrowing of the urethra, often due to injury or infection, which can cause painful urination and difficulty starting urination.