Differential Diagnosis for Pain or Burning Sensation when Voiding in Males

Single Most Likely Diagnosis

• Urinary Tract Infection (UTI): This is often the most common cause of dysuria (painful urination) in men, especially if they have had recent sexual activity or other risk factors for UTIs. Bacteria such as E. coli are common pathogens.

Other Likely Diagnoses

• Urethritis: Inflammation of the urethra, often due to sexually transmitted infections (STIs) like gonorrhea or chlamydia, can cause burning sensations during urination.
• Prostatitis: Inflammation of the prostate gland can cause pain during urination, among other symptoms like pelvic pain and discomfort.
• Kidney Stones: While not always causing a burning sensation, the pain associated with passing a kidney stone can sometimes be felt during urination and can be severe.

Do Not Miss Diagnoses

• Gonorrhea and Chlamydia: These STIs can lead to severe complications if not treated promptly, including infertility and epididymitis. Early diagnosis and treatment are crucial.
• Tuberculosis of the Urinary Tract: Although rare, it can present with symptoms of dysuria and needs to be considered, especially in high-risk populations or those with exposure history.

Rare Diagnoses

• Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can worsen as the bladder fills and may improve with urination.
• Bladder Cancer: While rare, it can cause painful urination among other symptoms like hematuria (blood in urine). It's more common in older adults and those with risk factors like smoking.
• Schistosomiasis (Bilharzia): In endemic areas, this parasitic infection can cause urinary symptoms, including dysuria, due to the eggs of the parasite causing inflammation in the urinary tract.