From the Guidelines
Dysuria after urethral dilation is a common and expected side effect that typically resolves within a few days, and management should focus on relieving discomfort and preventing complications, as recommended by the most recent guidelines 1. To manage this discomfort, several strategies can be employed:
- Drink plenty of water (at least 8-10 glasses daily) to dilute urine and reduce irritation.
- Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help reduce pain and inflammation.
- Warm sitz baths for 10-15 minutes several times daily can provide significant relief.
- Avoid potential irritants such as caffeine, alcohol, spicy foods, and acidic beverages until symptoms improve. It is essential to monitor for signs of complications, such as bright red blood in urine beyond light pink spotting, fever above 101°F, severe pain unrelieved by medication, or symptoms persisting beyond 3-4 days, and contact a healthcare provider immediately if these occur, as suggested by recent guidelines 1. The urethral dilation procedure stretches the urethra, causing temporary inflammation and irritation to the urethral lining, which typically heals within 72 hours, leading to complete resolution of dysuria, as supported by the American Urological Association guidelines 1. In terms of follow-up care, clinicians should monitor patients for symptomatic recurrence following dilation, and consider diagnostic tests such as urethrocystoscopy, urethral ultrasound, or retrograde urethrography (RUG) to detect or screen for stricture recurrence, as recommended by recent guidelines 1.
From the Research
Dysuria after Urethra Dilation
- Dysuria, or pain during urination, can be caused by various factors, including urinary tract infections, sexually transmitted infections, and urethral irritation 2, 3.
- Urethral dilation is a procedure that may be used to treat urethral strictures, but it can also cause dysuria as a side effect 4, 5.
- The evaluation of dysuria typically involves a urinalysis and urine culture to determine the underlying cause 2, 6.
- Treatment of dysuria depends on the underlying cause, and may include antibiotics for urinary tract infections or other treatments for non-infectious causes 2, 6.
- Studies have shown that urethral dilation may not provide significant benefits in terms of symptom improvement compared to other treatments, and may even cause complications such as transient stress incontinence 5.
- The long-term effects of urethral dilation and internal urethrotomy for urethral strictures have been studied, and the results suggest that these procedures may have varying degrees of success in terms of stricture-free rates and quality of life benefits 4.
Causes of Dysuria
- Urinary tract infections are a common cause of dysuria, and can be diagnosed using urinalysis and urine culture 2, 6.
- Sexually transmitted infections, such as chlamydia and gonorrhea, can also cause dysuria 2, 3.
- Urethral irritation or trauma, such as that caused by urethral dilation, can also lead to dysuria 4, 5.
- Other causes of dysuria include interstitial cystitis, bladder pain syndrome, and certain medications 3.
Treatment of Dysuria
- Antibiotics are commonly used to treat urinary tract infections, and the choice of antibiotic depends on the severity of the infection and the presence of any underlying medical conditions 6.
- Treatment of non-infectious causes of dysuria, such as interstitial cystitis or bladder pain syndrome, may involve medications, lifestyle changes, or other interventions 3.
- Urethral dilation and internal urethrotomy may be used to treat urethral strictures, but the effectiveness of these procedures can vary depending on the individual case 4, 5.