Find information on urination pain, also known as dysuria. Learn about the causes, symptoms, diagnosis, and treatment of painful urination in men and women. This resource covers related clinical documentation, medical coding (ICD-10 codes), and healthcare guidelines for managing urinary tract infections (UTIs), interstitial cystitis, sexually transmitted infections (STIs), and other conditions associated with dysuria. Explore differential diagnoses and understand the role of urinalysis, urine culture, and cystoscopy in evaluating painful urination.
Also known as
Other symptoms and signs involving
Covers other urinary system symptoms, including pain during urination (dysuria).
Other disorders of urinary system
Includes various urinary disorders that can cause painful urination.
Inflammatory diseases of female pelvic
Pelvic inflammatory diseases can cause urinary symptoms like painful urination.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the pain associated with urination related to a UTI?
Yes
Is the UTI localized to the bladder?
No
Is the pain due to an STD?
When to use each related code
| Description |
|---|
| Urination Pain (Dysuria) |
| Urinary Tract Infection (UTI) |
| Interstitial Cystitis/Bladder Pain Syndrome |
Q: What are the key differential diagnoses to consider when a patient presents with dysuria and frequency, and how can I effectively differentiate between them in a primary care setting?
A: Dysuria and frequency are common urinary symptoms with a wide differential diagnosis including urinary tract infection (UTI), sexually transmitted infections (STIs) like chlamydia or gonorrhea, interstitial cystitis/bladder pain syndrome (IC/BPS), urolithiasis, and even less common conditions like bladder cancer. In a primary care setting, differentiating between these requires a thorough history, including sexual history, onset and character of pain, associated symptoms like fever or hematuria, and any relevant risk factors. A urinalysis with microscopy and culture is essential. If STI is suspected, appropriate nucleic acid amplification tests (NAATs) should be ordered. Consider a pelvic exam in women and a digital rectal exam in men to assess for prostate involvement. If initial investigations are negative and symptoms persist, consider further imaging like ultrasound or cystoscopy and referral to urology for suspected IC/BPS, urolithiasis, or other complex conditions. Explore how point-of-care testing can expedite diagnosis and treatment in your practice.
Q: Beyond antibiotics, what evidence-based non-pharmacological and pharmacological management strategies are recommended for chronic pelvic pain syndromes contributing to urination pain, specifically in female patients?
A: Chronic pelvic pain in females, encompassing conditions like IC/BPS and endometriosis, often presents with urination pain and requires a multidisciplinary approach beyond simple antibiotics. Non-pharmacological strategies include pelvic floor physical therapy, cognitive behavioral therapy (CBT) for pain management, and lifestyle modifications like dietary changes (e.g., avoiding bladder irritants) and stress reduction techniques. Pharmacological options can include analgesics, antidepressants (like amitriptyline) for pain modulation, and anticholinergics (like oxybutynin) for bladder spasms, depending on the specific diagnosis. For IC/BPS specifically, intravesical instillations with medications like DMSO or heparin may be considered. Consider implementing a collaborative care pathway involving physical therapy, pain specialists, and mental health professionals to provide holistic care for these complex patients. Learn more about current guidelines for managing chronic pelvic pain.
Patient presents with dysuria, characterized as burning or painful urination. The onset of this urinary pain was (onset timeframe). Associated symptoms may include urinary frequency, urgency, hesitancy, nocturia, and suprapubic pain or discomfort. Patient denies (or reports) fever, chills, flank pain, nausea, vomiting, hematuria, or vaginal discharge. Medical history includes (list relevant medical history, e.g., diabetes, hypertension, previous UTIs, kidney stones, BPH, STIs, surgeries). Surgical history includes (list relevant surgical history). Medications include (list current medications). Allergies include (list allergies). Physical examination reveals (relevant physical exam findings e.g., suprapubic tenderness, costovertebral angle tenderness). Differential diagnosis includes urinary tract infection, urethritis, cystitis, pyelonephritis, prostatitis, sexually transmitted infection, interstitial cystitis, bladder stones, and urethral stricture. Preliminary diagnosis is (preliminary diagnosis, e.g., UTI, cystitis). Plan includes urinalysis, urine culture, and (additional tests as indicated, e.g., STI testing, pelvic exam, prostate exam, imaging studies). Patient education provided regarding adequate hydration, hygiene practices, and potential complications of untreated urinary tract infections. Follow-up scheduled in (timeframe) to review results and discuss further management. Patient advised to return sooner if symptoms worsen or new symptoms develop, such as fever, chills, or flank pain. Coding considerations include ICD-10 codes for dysuria (R30.0), urinary tract infection (N39.0), or other relevant diagnoses based on final determination.