What causes painful urination after appendectomy?

Oct 30, 2025 Source: Cainiu Health

Dr. Wang Lei

Introduction

Pain during urination after appendectomy may be caused by incomplete voiding due to bed rest, insufficient fluid intake, acute urethritis, cystitis, or urethral spasm. It can be improved by adjusting urination posture, increasing fluid intake, medication, and antispasmodic treatment. If the pain persists or is accompanied by urgency, hematuria, or other symptoms, prompt medical attention is necessary.

　　Pain during urination after appendectomy may result from incomplete voiding due to bed rest, insufficient fluid intake, acute urethritis, cystitis, or urethral spasm. Adjusting urination posture, increasing fluid intake, and medication can help alleviate symptoms. If pain persists or is accompanied by urgency, hematuria, or other symptoms, prompt medical attention is necessary.

　　1. Incomplete voiding due to postoperative bed rest: Prolonged bed rest after surgery alters normal urination posture, leading to urine retention in the bladder, which irritates the urethral mucosa and causes painful urination; some individuals may also experience difficulty urinating. It is recommended to adjust the urination position under medical guidance—such as lying on one's side or using a bedpan—and to get out of bed as soon as medically safe to promote normal urination.

　　2. Insufficient fluid intake: Reduced fluid consumption due to poor appetite or concerns about wound discomfort during urination can lead to concentrated urine. This increases irritation of the urethra by harmful substances and worsens pain, often resulting in dark yellow urine. Increasing daily water intake to maintain urine output between 1500–2000 mL helps dilute urine, reduce urethral irritation, and relieve discomfort.

　　3. Acute urethritis: Postoperative decline in immunity allows bacteria such as *Escherichia coli* or *Staphylococcus* to enter through the urethra, causing acute inflammation of the urethral mucosa. This leads to painful urination, often accompanied by urgency, frequency, redness and swelling of the urethral opening, and minor discharge. Under medical supervision, medications such as levofloxacin capsules, cefixime dispersible tablets, or Sanjin tablets may be used to relieve symptoms.

　　4. Cystitis: Bladder mucosal congestion and edema may occur due to irritation from urinary catheters or bacterial infection after surgery. When the bladder contracts, it stimulates inflamed tissue, causing pain during urination, along with lower abdominal discomfort and a feeling of incomplete voiding. Under medical guidance, medications such as norfloxacin capsules, sodium bicarbonate tablets, or nitrofurantoin enteric-coated tablets may be prescribed to manage symptoms.

　　5. Urethral spasm: Pain from surgical wounds or procedures such as catheter insertion or removal can trigger spasms of the smooth muscles in the urethra, resulting in episodic pain that worsens during urination. Follow medical advice to use antispasmodic drugs such as belladonna tablets, raceanisodamine tablets, or phloroglucinol injection to alleviate symptoms.

　　Daily care should include keeping the urethral opening clean by washing with warm water daily; avoiding urinary retention by urinating promptly when needed; maintaining a light diet and avoiding spicy or irritating foods; and ensuring adequate rest to support recovery and reduce the risk of complications.

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What should I do if I have appendicitis?

In case of appendicitis, seek medical attention promptly for diagnosis, choose surgical treatment based on the condition, follow medical advice for anti-infective medications, avoid strenuous activities, and adjust diet accordingly. If persistent pain in the lower right abdomen, fever, or vomiting occurs, immediately visit a general surgery department. Once symptoms suggestive of appendicitis appear, go to the hospital as soon as possible for diagnostic tests such as complete blood count and abdominal ultrasound to confirm the diagnosis.

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How long does it take to fully recover after appendicitis surgery?

The recovery time after appendectomy varies depending on the surgical approach. For laparoscopic minimally invasive surgery, full recovery usually takes 2–4 weeks, while open abdominal surgery requires 4–6 weeks. If complications such as wound infection or worsening abdominal pain occur after surgery, patients should immediately seek care from a general surgery department. Laparoscopic minimally invasive surgery involves less trauma, reduced blood loss, and results in milder postoperative pain.

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What does rebound tenderness mean in acute appendicitis?

Rebound tenderness in acute appendicitis may result from inflammation of the appendix stimulating the peritoneum, visceral nerve reflexes, localized peritonitis, peri-appendiceal abscess, or appendiceal perforation. This can be managed through rest and immobilization, anti-inflammatory medications, or surgical treatment. If rebound tenderness worsens or is accompanied by high fever, chills, or other severe symptoms, immediate medical attention is required. During acute appendicitis, the appendix becomes congested and swollen.

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What should one eat for meals with chronic appendicitis?

Patients with chronic appendicitis should consume light, easily digestible staple foods, low-fat high-quality protein sources, vegetables rich in dietary fiber, mild fruits, and soft, easily absorbed soups and broths. Proper dietary adjustments can help reduce intestinal burden. If symptoms such as worsening abdominal pain or fever indicating acute exacerbation occur, immediate medical consultation at the general surgery department of a hospital is necessary.