Infection (most common cause):
- Bacterial cystitis (e.g., E. coli, S. saprophyticus)
- Rationale: Dysuria, frequency, urgency, suprapubic pain.
- Sexually transmitted infections (e.g., Chlamydia, Gonorrhea)
- Rationale: Often accompanied by vaginal discharge or pelvic pain.
- Vaginitis (e.g., yeast, bacterial vaginosis)
- Rationale: May cause external dysuria due to inflammation.
- Non-infectious causes:
- Urethral stricture (post-inflammatory or traumatic)
- Rationale: May present with weak stream, straining.
- Interstitial cystitis/bladder pain syndrome (IC/BPS)
- Rationale: Chronic pelvic pain, urinary urgency.
- Chemical irritants (e.g., spermicides, soaps)
- Rationale: External dysuria without systemic symptoms.
- Next steps:
- Urinalysis (leukocytes, nitrites, RBCs) to assess for infection.
- Culture if symptoms persist or recurrent.
- Consider pelvic exam for STIs/vaginitis if indicated.