Dysuria refers to pain or a burning sensation with urination.  Urinary tract bacterial infections (cystitis, urethritis) are the most common cause of dysuria.  Other disorders or atypical pathogens (mycobacteria, fungal agents, etc.) should be considered when symptoms prove refractory to initial antibiotic therapy or if symptoms occur and culture of the urine yields no identifiable infectious etiology.  If symptoms are refractory to antibiotic therapy, it is important to assure that the infectious agent was sensitive to the antibiotic used, that the patient is not suffering from reinfection, that the patient does not suffer from urinary tract structural abnormalities or staghorn calculi, and that the patient was compliant with the full course of therapy. The pathogens Ureaplasma urealyticum and Mycoplasma hominis require special culture media to confirm the diagnosis.  Other common causes of dysuria include passage of stones, tumors, prostatitis, sexually transmitted infections (Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and genital herpes), fungal cystitis/urethritis, and interstitial cystitis.