Urethral pain syndrome

Urethral pain syndrome is the name for a group of symptoms that make peeing painful or difficult, even though there’s no infection or clear medical cause. It’s more common in women, but anyone can get it.

The symptoms can feel a lot like a urinary tract infection (UTI) or urethritis (inflammation of the urethra, the tube that carries urine from your bladder out of your body when you pee.). But unlike those conditions, urethral pain syndrome doesn’t happen because of a known infection.

You might notice:

• Needing to pee more often than usual.
• Feeling like your bladder isn’t empty after you pee.
• Pain while urinating or pain in your lower tummy.
• A sudden, urgent need to pee.
• Pain in your lower back or around your genitals.
• Pain during sex.
• Blood in your urine.
• Swollen testicles, pain while ejaculating, or blood in your semen (in men).

Pain and quality of life assessment
You may be asked to fill out a questionnaire about your pain—how often it happens, how strong it is, and how it’s affecting your life, including things like your mental health or sexual wellbeing.

Physical examination
Your doctor may need to examine your genitals and press gently around your lower tummy and pelvis to check for pain, lumps, or anything unusual. It can feel a little awkward, but the exam is important for understanding what’s going on.

Urine test
You’ll be asked to give a urine sample to check for signs of infection. Depending on where you’re being seen, this might be tested on-site or sent to a lab.

Sexually transmitted disease (STD) check
Even if you don’t think you’ve been exposed to an STI recently, your doctor may suggest a urethral swab. This is a quick test where a small, soft stick (like a cotton swab) is gently inserted a short way into the urethra, the tube that carries urine from your bladder out of your body when you pee, to check for infections like chlamydia or gonorrhoea. These can cause pain and other symptoms even if you don’t have any obvious signs.

• For women: A small cotton bud is gently placed into the urethra to collect a sample. A second sample might be taken from your cervix.
• For men: The swab is gently inserted about 2 cm into the urethra.

The test can be uncomfortable, but it’s quick.

Cystoscopy
A cystoscopy is a test where a thin camera (called a cystoscope) is inserted into your urethra to check inside your bladder for any other possible causes of your symptoms.

This video shows how a cystoscopy is done in more detail. 

Ultrasound
An ultrasound uses sound waves to create images of your pelvic area. It helps your doctor get a clearer view of your bladder, urethra, and nearby tissues.

This chapter contains general information about urethral pain syndrome. It is not a substitute for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.

Last updated: April 2025