Urination Burning

WHEN TO SEE YOUR DOCTOR

* The burning persists for more than 24 hours after you've tried self-help remedies.

* Burning is accompanied by a discharge from your vagina or penis.

* In addition to burning, you urinate frequently, feel sudden urges to urinate or experience any flulike symptoms, fever, chills or back pain.

What Your Symptom Is Telling You

Complaints of burning upon urination, often accompanied by frequent urges to urinate, send eight million women to the doctor's office every year. The usual source of the problem is a urinary tract infection (UTI). One out of every five women gets a urinary tract infection at least once a year, and of those, 15 percent contract more than three a year.

Why are women so prone to UTIs?

Both the rectum and the vagina are perfect incubators for bacteria that all too easily find their way to the nearby urethra, the exit tube for urine. And since the female urethra is not very long, it provides an easy route for the bacteria to invade the bladder, causing cystitis. The bacteria can even move farther upstream to the kidneys, causing a more serious infection called pyelonephritis.

Men have longer urethras, and the prostate gland secretes bacteria-fighting substances that provide a barrier against infections. "It's unnatural for a man to get a urinary tract infection," says John P. Long, M.D., assistant professor of urology in the Department of Urology at Tufts University New England Medical Center in Boston. "When men experience burning as they urinate, it's nothing to be trifled with."

For men, burning urination may signal a sexually transmitted disease, such as gonorrhea or chlamydia. An inflamed prostate--a condition called prostatitis--can also cause a burning sensation.

A number of other factors can cause or aggravate a burning sensation when you urinate, according to Tamara G. Bavendam, M.D., assistant professor of urology and director of female urology at the University of Washington Medical Center in Seattle. Possible irritants include spicy foods, coffee, Yeast infections can also cause burning.

Symptom Relief

Depending on the cause, there are a few keys to getting rid of that burning sensation. Eliminate the bacteria that cause infections or avoid the irritants. These tips will help you do just that.

Flood your bladder. At the first hint of burning, drink two eight-ounce glasses of water, recommends Kristene E. Whitmore, M.D., chief of urology at Graduate Hospital in Philadelphia, clinical associate professor of urology at the University of Pennsylvania and coauthor of Overcoming Bladder Disorders. Then dissolve one teaspoon baking soda in four ounces water and drink that. Then, for the next six to eight hours drink eight ounces of water every hour. Consult your doctor if the symptom is not relieved after a day.

What you're doing is diluting your bacteria-filled urinary tract and forcing yourself to urinate, rather than holding it in, which prolongs the infection. "Oftentimes, the water is enough to flush out the bacteria and make your symptoms tolerable," Dr. Whitmore says. "Sometimes that's all that's needed."

See the doctor. If the burning remains after a day, you should see the doctor. If you're experiencing the burning for the first time, you'll need to give the doctor a urine specimen to check for bacteria. The doctor also will check for a yeast infection or sexually transmitted disease. If you're a man, a prostate examination will be done.

Antibiotics in combination with the baking soda and water may rid you of the problem, but if it persists or recurs, more extensive testing will be required, Dr. Whitmore says. That could include more urine cultures, an ultrasound of your kidneys or running a scope up your urethra for a close-up look at your bladder.

Don't feed the burn. Many foods and drinks can irritate the urinary tract, either causing or aggravating the burning, Dr. Baven- dam says. These include alcohol, coffee, Eliminating all of these foods from your diet can ease the burning and other urinary discomforts within about ten days, according to Dr. Bavendam. Once the burning sensation is gone, you can start adding them back to your diet one at a time to see which substance (or substances) is causing a problem. As you do so, she emphasizes, drink a minimum of one quart of water throughout the day.

Ease the pain. Urinating through an inflamed urethra or letting urine touch infected or raw skin is like rubbing salt into an open wound. To ease that pain, try urinating while sitting in a tub of warm water or while standing in the shower, Dr. Bavendam suggests.

Wipe right. If you're a woman, wipe yourself from front to back after a bowel movement. Doing the reverse can more easily sweep bacteria from your rectum into your urethra.

Practice clean sex. Sex can be a significant source of burning by irritating the urethra or introducing bacteria. "Urinate after having sex," Dr. Bavendam suggests. And after you urinate, says Dr. Whit- more, wash your vagina with a hand-held showerhead or bathe it in some water with a tablespoon or so of baking soda.

Stay free of chemicals. Pay particular attention to whether soaps or hygiene products cause irritation, Dr. Bavendam says. Bubble baths, douches, deodorants and scented toilet papers all contain chemicals that can irritate your urethra or the skin surrounding it.

Dry up. In the summer, don't lounge about in a wet bathing suit, which may stimulate a vaginal yeast or bacterial infection. "Wash off the chlorine," Dr. Whitmore says. "And I tell women to carry a spare bathing suit. Change into the dry one after swimming." (For other hints on avoiding yeast infections, see Vaginal Itching on page 587.)