• You experience painful urination which lasts for more than one day, or, if you are pregnant, if you have any painful urination.
• There is drainage or a discharge from your penis or vagina.
• You notice blood in your urine.

• Time pattern: When did the painful urination begin?
• Quality
  • Does the pain occur only during urination?
  • Does the pain stop after urination?
• Location
  • Is the pain in the urethra?
  • Is there back pain?
• Other
  • What other symptoms are also present?
    • Have you had a fever higher than 100 degrees F?
    • Is there drainage or discharge between urinations?
    • Is there an abnormal urine odor?
    • Are there any changes in the volume or frequency of urination?
    • Do you have the urge to urinate?
    • Was any blood in the urine noticed?
    • Are there any rashes or itching in the genital area?
  • What medications are you taking?
  • Are you pregnant or could you be pregnant?
  • Has there been a previous bladder infection?
  • Do you have any allergies to any medications?
  • Have you had sexual intercourse with someone who is known to have gonorrhea or chlamydia?
  • Has there been a recent change in the brand of soap, detergent, or fabric softener?
  • Have you had surgery or radiation to your urinary or sexual organs?

With previous bladder or kidney infections, a more detailed history and physical are needed, and extra laboratory studies may be necessary. In women with a vaginal discharge, an examination of the vagina and any discharge is necessary. Men who have penile discharge will need to have a urethral swab done.

Diagnostic tests:

Your health care provider will probably start with an office urine dipstick. Based on those results, a urine culture may be ordered. DNA probes for gonorrhea or chlamydia may also be obtained.

Treatment:

If a urinary tract infection is confirmed or highly suspected, treatment will include the prescription of an antibiotic. If appropriate, pain medications will be administered. If gonorrhea or chlamydia is suspected, your health care provider will provide you with antibiotics to treat these infections, usually even before the lab can confirm the infection, and instructions on notifying your sexual partner(s) for treatment.

If vaginitis or vulvitis is diagnosed, your health care provider will recommend appropriate treatment.

Other medications or surgical treatment may be necessary depending on the cause of the discomfort.