Painful or frequent urination is a common problem, especially in older men. Urinary tract infections, kidney stones and prostate problems can all produce these symptoms. Frequent urination without pain also can be a side effect of certain medications, or a symptom of diabetes.

Most men who experience new problems with painful or frequent urination should see their doctor. This guide is intended to provide helpful information while you are awaiting further evaluation, or can add to what you may have already learned after your visit with a doctor.

Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider.

Pain or burning during urination and frequent urination can be caused by the same medical condition. However, it's helpful to focus on one symptom or the other.

Choose which symptom is presently bothering you the most.

I have frequent urination.

I have pain or burning with urination.

Pain or burning can be a sign of a several different medical conditions, including

• a urinary tract infection

• a prostate problem, such as a prostate infection

• a sexually transmitted disease

• kidney stones.

Have you noticed a discharge from the tip of your penis?

Yes, I've noticed a discharge from my penis.

No, I have not noticed a discharge.

Good -- that makes urethritis less likely; urethritis is usually due to a sexually transmitted disease such as gonorrhea or chlamydia.

Some very serious urinary tract infections may cause pain or burning during urination; these infections are often associated with other symptoms, such as

• a fever above 100.5F

• shaking chills

• severe back pain

• pain behind the bladder, deep in the pelvis or behind the scrotum

• nausea or vomiting

• a new rash.

Have you had any of these symptoms along with pain or burning during urination?

Yes, I have had one or more of these symptoms.

No, I have not had any of these symptoms.

Contact your doctor. Even without these symptoms, you need a medical evaluation to explain why you are having pain or burning during urination. Possible causes include

• a urinary tract infection

• infection or inflammation of the prostate gland

• infection or inflammation of the urine tube (urethritis).

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

Yes, I'd like to learn more.

I'm all set, time to quit.

Contact your doctor immediately. You may have a serious urinary tract infection such as pyelonephritis or acute prostatitis. You should have prompt evaluation and may need to start antibiotic treatment urgently.

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

Yes, I'd like to learn more.

I'm all set, time to quit.

Contact your doctor. A discharge from the penis that occurs with pain during urination could be due to urethritis. The discharge may be clear, green, yellow or gray, but any discharge should be evaluated by your doctor. Most cases of urethritis are caused by sexually transmitted disease such as gonorrhea or chlamydia. You should have a medical evaluation, and may need antibiotic treatment. It's important that you avoid sexual contact until you have been evaluated and treated; if you do have a sexually transmitted disease, your sexual partners should be notified, evaluated and treated as well.

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Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

Frequent urination can be a sign of several different medical conditions. Sometimes the problem is located in the urinary tract -- for example, an enlarged prostate can cause this -- but sometimes a system-wide medical problem, such as diabetes, can produce the same symptoms.

To sort out the cause of your symptoms, it will be helpful for you to answer some additional questions about symptoms.

Let's first find out what your urine looks like, since blood in the urine usually points to a problem in the urinary tract itself. You may notice a pink or red tinge to the urine, or small clots. Blood in the urine can also have a dark color, like cola.

Have you noticed any blood in your urine?

Yes, I've noticed blood in my urine.

No, I have not noticed blood in my urine.

Good. Next, it's important to find out if you've had other symptoms that can signal a serious urinary tract infection, such as

• a fever above 100.5F

• shaking chills

• severe back pain

• pain behind the bladder, deep in the pelvis or behind the scrotum

• nausea or vomiting

• a new rash.

Have you had any of these symptoms along with pain or burning during urination?

Yes, I've had one or more of those symptoms.

No, I've not noticed any of those symptoms.

Good. That makes a serious infection requiring urgent treatment less likely.

Loss of urine control can also be a sign that your frequent urination is coming from a problem with your bladder or prostate gland. You may notice severe urgency, or leakage of urine into your underwear, or loss of bladder control during sleep.

Have you noticed any problems controlling your urine?

Yes, I've had problems controlling my urine.

No, I've not had problems controlling my urine.

So far you have indicated that you that your urine is not bloody, you don't report symptoms of serious illness, and urinary control is no problem.

Some men are able to control their urine, but have difficulty getting urine out of their bladder. Symptoms that signal difficulty passing the urine include

• difficulty starting the urine stream

• slow or weak urine stream

• dribbling after urination

• needing to urinate twice within a few minutes.

Have you noticed any difficulty passing your urine?

Yes, I've had difficulty passing my urine.

No, I have not had problems passing my urine.

Good! This makes a prostate problem less likely.

In some men, frequent urination can be a sign of a medical condition such as diabetes or congestive heart failure rather than a problem with the urinary organs. These other medical problems may be signaled by symptoms such as

• unusual thirst

• weight gain or weight loss

• blurry vision

• shortness of breath.

Have you noticed any of these symptoms?

Yes, I've noticed one or more of these symptoms.

No, I've not had any of these symptoms

Some medications can also cause frequent urination.

Are you taking any new medications, either with or without a prescription?

Yes, I am taking one or more new medications.

No, I am not taking any new medications.

Stopping a new medication may help to relieve your symptoms. However, if the medication was prescribed by a doctor, contact that doctor before stopping the medication.

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Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

Contact your doctor. Unusual thirst, changes in weight, blurry vision or shortness of breath can be a sign of serious medical problem. You should have a medical evaluation.

You've completed this Decision Guide!

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

Difficulty passing urine is often a sign of a prostate problem, such as an enlarged prostate or chronic prostatitis.

Certain medications can cause or aggravate these symptoms, including certain over-the-counter cold products and many prescription drugs.

Have you recently started taking any new medications, either by prescription or over the counter?

Yes, I recently began taking a new medication.

No, I am not taking any new medications.

Your symptoms could be caused by a prostate problem, although there could be other factors playing a role. For example, even a medication you've been taking for a while could cause trouble if your prostate has been enlarging over time.

Contact your doctor. You should have a medical evaluation.

If you have an enlarged prostate, there are a number of ways to handle the problem:

• Use the bathroom well before the situation becomes urgent. Give yourself enough time to empty the bladder completely.

• Don't drink fluids within a few hours of bedtime.

• Limit alcohol intake. The current recommendation for men is no more than two alcoholic beverages per day.

• Review your medications with your doctor, as diuretics, decongestants, certain antidepressants and many other drugs can worsen symptoms.

• Consider medication treatment -- although mild symptoms may need no treatment, review the available treatment options with your doctor, including tamsulosin (Flomax), alfuzosin (UroXatral), doxazosin (Cardura), terazosin (Hytrin), finasteride (Proscar) and dutasteride (Avodart).

• Consider surgery -- for severe symptoms, especially when medications do not work well, surgery may be recommended to remove prostate tissue.

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Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

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I'm all set, time to quit.

Stopping this new medication may help to relieve your symptoms. However, if the medication was prescribed by a doctor, contact that doctor before stopping the medication! Tell him or her about your urinary problems and your concern that one or more of your medications may be to blame.

You've completed this Decision Guide!

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

Yes, I'd like to learn more.

I'm all set, time to quit.

Contact your doctor. Loss of bladder control may signal a urinary tract infection, a problem with the bladder or prostate, or a problem with the nervous system. New loss of bladder control always deserves a medical evaluation.

You've completed this Decision Guide!

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

Contact your doctor immediately. You may have a serious urinary tract infection such as pyelonephritis or acute prostatitis. You should have prompt evaluation and may need to start antibiotic treatment urgently.

You've completed this Decision Guide!

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

A number of different urinary conditions can make blood appear in the urine. (The medical name for blood in the urine is hematuria). In young men, kidney stones are a common cause. In older men kidney stones are also common, but prostate problems and bladder tumors become more of a concern.

Contact your doctor. Blood in the urine deserves a medical evaluation. If you are passing large blood clots, contact your doctor immediately, since these blood clots can block the bladder.

You've completed this Decision Guide!

Would you like to learn more about causes of painful or frequent urination? Or, would you prefer to quit now?

I'm all set, time to quit.

Yes, I'd like to learn more.

Good! Here are some of the most common causes of painful or frequent urination in men:

• chronic prostatitis

• congestive heart failure

• diabetes

• kidney stones

• prostate enlargement

• prostate infection

• prostatitis (prostate inflammation), acute or chronic

• pyelonephritis

• sexually transmitted disease, including gonorrhea and chlamydia

• urinary tract infection

• urethritis

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