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"What causes urinary pain (not UTI or STD)?"
My girlfriend always has painful urination and increased urgency the day after we have sex. We've both been tested for a multitude of STDs, and though she was prescribed anti-biotics for a UTI, they generally don't help. She's undergone all manner of tests and smears and things, but neither we nor the doctors she visits can give any solid answers. Help?
By far the most common cause of painful urination after sexual intercourse in women is a urinary tract infection. This occurs because the urethra is very short, and bacteria can essentially be "pushed' into the urethra during intercourse and then climb up into the bladder. If her doctor has evaluated her for urinary tract infection and this has not been confirmed, then another possibility would be simply local irritation of the urethra, called urethritis. This can also occur after sex even in the absence of a urine infection. Generally speaking generic urethritis after sex can be managed by making sure to urinate right away after sex to flush out the urethra. Drinking plenty of fluids before and after sex will also help, because the increased volume of urine will help reduce the chance of inflammation. In any case, she should make a follow up appointment with her OB GYN doctor, who will be able to perform a complete examination and help determine whether additional measures are needed. Occasionally, persistent cases of pain like this do need a specialty referral to a urologist, but her OB GYN doctor will be able to help determine if this is necessary.
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