Does my husband have an STD?

For two days now, my husband says he feels a burning sensation when he passes urine. We have been intimate but I don’t have or feel any issues myself. What is the issue?

Dear Deborah,

You have not specified the age of your husband. In a young adult, burning sensation while passing urine occurs most commonly due to gonococcal infection of the urethra (tube connecting bladder to the exterior). It is sexually acquired as well as a transmitted infection. It is of acute onset. Here, painful urination is associated with urethral discharge, which happens most in the morning (called bon jour drop because of the narrowing of the opening of the urethra (urethral stricture). The infection can spread to other parts like the urinary bladder, testes, epididymis prostate. Infection by other microbes, apart from gonococci, other non-gonococcal infections can also cause infection and inflammation of any one or more of these parts, causing painful urination, frequency of urination as well as urgency to pass urine. Those with reduced immunity like individuals with uncontrolled diabetes, renal failure, HIV/AIDS, are more vulnerable to these infections and can develop them in a more severe form.

Elderly men are prone to repeated urinary bladder infections, due to enlarged prostate. Enlarged prostate causes obstruction to easy flow of urine, causing small amount of residual urine to remain permanently in the bladder. This becomes a source of infection as stagnant urine becomes a good media for microbes to grow. This manifests in form of frequent urination with passing of small amounts of urine which happens more in the night, dribbling of urine, painful urination and urgency to pass urine.

Any infection causing painful urination can be detected by microscopic examination of the urine and culture of the sample. This confirms the presence of infection and demonstrates the causative organisms. Treatment is by taking full course of a suitable antibiotic.

One is also prone to recurrent infection of the bladder, due to congenital abnormalities like short length of the urethra or urethral stricture. Infections of the kidney or ureter (tubes connecting kidney to the bladder) can spread to the bladder, causing painful urination. One can have painful urination due to stones in the urinary system, particularly in the ureters, bladder or urethra. Presence of stones causes obstruction to the flow of urine, and residual stagnant urine becomes a source of infection.

Presence of congenital abnormalities or stones in urinary system is diagnosed by ultrasound examination. Treatment is by medicines to control the infection, drinking lots of water and surgical intervention if needed and feasible.

Prevention of urinary tract infections and kidney stones lies in drinking adequate amount of water. Drinking enough water helps to cleanse the urinary system of microbes, as well as small stones by flushing them out in urine. Sticking to one sexual partner and avoiding sex outside marriage helps in preventing sexually transmitted diseases, which can cause painful urination. Using a good quality condom is also helpful.  If the partner has any symptoms of a sexually transmitted disease, avoid sex with that person and motivate him/her to take treatment.                                     

 Dr.Rachna  Pande is a specialist in internal medicine.