Why Does It Burn When You Pee? What to Do When It’s Not a UTI

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Why does it burn when you pee?
Author Name: Lucas Cook
Date: Thursday June 6, 2024

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Your morning trip to the bathroom hurts so badly that you immediately call into work to visit Urgent Care. However, after filling your cup, the doctor says you show no signs of bladder infection. How can this be when it burns when you pee, the most obvious symptom of a UTI?  

Several possible answers exist. The issue could lie with the UTI test or contaminants or could signify a different underlying issue. Getting to the bottom of the problem can be a long and challenging road, but knowing what to do makes the process easier. Here’s what to do when you don’t know why it burns when you pee, and the discomfort continues to disrupt your life despite a negative urine test. 

How Common Are False Negatives on UTI Tests? 

First of all, take a deep breath. Please don’t think that you are imagining your pain. There are several reasons why your doctor could report a negative UTI test result, even when you display all the symptoms of a bladder infection. You might have a different underlying problem altogether. 

However, it’s also possible that your test results were inaccurate. 15% to 20% of UTI tests produce a false negative, meaning that yes, Virginia, you may have an infection after all. Getting treatment still matters. Recurrent bladder infections rarely snowball into worsening health woes, but complications can occur — please keep seeking answers. 

What Causes False Negatives on UTI Screenings? 

False negatives can occur when bacterial colonies remain too low but nevertheless produce symptoms. They also happen when the specific test used doesn’t screen for the strain of bacteria causing your woes. Many tests check for the usual suspects, but other nasties can sneak into your bladder and kick up trouble. 

Why It Might Burn When You Pee When It’s Not a UTI 

Of course, your underlying problem might not be a bladder infection at all. Here are eight reasons why it might burn when you pee, even if you don’t have a UTI. 

Please note that many of these conditions still require medical care. Finding a reliable care team can be challenging, but it is a must to get answers. The unfortunate reality of doctors’ offices is that they often have little time to spend with you, and you have to take a proactive approach and be persistent to find the help you need. 

1. Cystitis or Interstitial Cystitis 

“Cystitis” simply means “inflamed bladder.” The inflammation source could be multiple things, from an allergy to something you wear, use or eat to chemical imbalances in your body that create widespread, systemic issues. For example, one woman repeatedly found it burned when she peed after using a certain brand of toilet paper — switching to an unscented, natural type did the trick. 

Interstitial cystitis refers to a chronic condition that causes recurrent or near-constant bladder inflammation. Those affected often have lower pelvic pain and issues with sex. Other symptoms include urinary urgency and frequency. For this reason, many doctors first try traditional overactive bladder treatments. If these don’t work, you should suspect IC, as this condition of exclusion may require alternatives like nerve stimulation to manage. 

2. Sexually Transmitted Diseases 

Several sexually transmitted diseases can cause symptoms similar to a UTI, including:

  • Chlamydia 
  • Gonorrhea
  • Syphilis
  • Herpes
  • Trichomonos vaginalis or trich
  • HIV 

However, please note that a standard urinalysis test doesn’t detect every STD, so following up with your doctor is crucial to protect any partners you have. Furthermore, your provider might not know what to check for. Be upfront about your sexual activity and request additional screenings if you have symptoms. 

3. Urethral Stricture Disease 

Urethral stricture disease occurs when scar tissue from injury or illness restricts the tube that carries urine out of the body. Although it’s more common in men because of their longer urethra, it also occurs in women, especially those with repeated infections. It’s also common in those who regularly use catheters. Further diagnostic testing via ultrasound, MRI or cystoscopy reveals this cause, which is treated by catheterization, dilation or sometimes surgery. 

4. Kidney or Bladder Stones 

Stones often occur when there is too little water in your body, causing calcium in your urine to solidify. It pays to stay hydrated, and doing so is one of the best preventative medicines for protecting bladder health.

Kidney stones can cause considerable lower back pain, and those that move to the bladder spur UTI-like symptoms. Other types of stones besides calcium include: 

  • Uric acid stones, which result from too much acid in the urine, often the result of an overly meat-rich diet. 
  • Struvite stones, which often occur with infection and consist of ammonium, magnesium and phosphate. These can strike when you leave a bladder infection untreated and may require surgical removal — seek help when needed. 
  • Cystine stones occur from a rare, inherited disease that often causes lifelong issues. 

5. Yeast Infection 

Yeast infections can sometimes cause symptoms similar to UTIs. However, you can often tell them apart by the smell or lack thereof, as yeast infections tend to smell “bready” and involve a whitish discharge. Itchiness down there is another sign, as is a lack of urgency. 

6. Bacterial Vaginosis 

Bacterial vaginosis stems from a different cause than yeast infections — a bacteria instead of a fungus — but produces similar symptoms. You might also distinguish them by discharge and smell, although BV often has a fishy odor. 

7. Cancer or Cancer Treatments

Although an association exists between frequent UTIs and bladder cancer, having one does not mean you will progress to the other. Bladder cancer remains relatively rare. Researchers believe that the inflammation damages the lining. Furthermore, having cancer or going through treatment changes the bladder lining, which may make you more prone to infections.  

8. Prostatitis 

This condition only affects men who have an intact prostate. However, an inflamed prostate can cause UTI symptoms, including burning, urgency and frequency. The infection may stem from a sexually transmitted disease or a bacterial infection, and proper medical follow-up care is necessary for those affected to protect themselves and their partners. 

How to Get Relief If It Burns When You Pee 

Burning when you pee can keep you trapped in your house if urgency and frequency grow severe enough. Here are some general tips you can follow to get relief and prevent future infections: 

  • Stay hydrated: Carry that flask with you everywhere and set phone alarm reminders if you forget to sip up. 
  • Take a probiotic: Your entire body has a microbiome, not only your gut. Good bacteria keep the bad kind in check, and at least one recent study suggested that taking a probiotic can reduce the frequency and severity of symptoms in those with recurrent infections. 
  • Use an OTC painkiller: NSAIDs, including aspirin, ibuprofen and naproxen work by reducing inflammation, while acetaminophen binds to pain receptors in your brain to reduce symptom severity. 
  • Take a hot bath: Lying in a warm bath can relieve the pain and let you void as frequently as necessary. 
  • Drink pomegranate or cranberry juice: These contain antioxidant polyphenols and proanthocyanidins that prevent infection-causing bacteria from adhering to your bladder walls. They also help you maintain a consistent pH and prevent yeast infections. 

Navigating the Complicated Medical System

If it burns when you pee, but your urinalysis comes back negative, you should continue seeking answers. However, that can be tough in the United States, where millions of people lack coverage, and others struggle with high deductibles and copays. 

If you don’t have coverage, check your options. Use the tool at Healthcare.gov to see if you qualify for no or low-cost coverage through your state’s Medicaid system or the Marketplace. Pay attention to out-of-pocket expenses when selecting a plan, as deductibles and copays vary considerably. 

Unfortunately, the emergency room isn’t designed for ongoing care, although many people turn to it as their only way to obtain treatment. Be honest with the admitting personnel about your financial circumstances. While they cannot provide ongoing treatment and testing, they may offer referrals to financial aid resources or connect you with sliding-scale clinics that may provide the services you require. 

Find Out Why It Burns When You Pee 

If you wonder, “why does it burn when I pee,” you need answers. Getting speedy treatment can cure a urinary tract infection or let you know that you have more detective work to do. 

Consider the possibilities above if you have UTI symptoms but your urinalysis comes back clean. Discovering the underlying issues improves your overall health and quality of life. 

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