At the time of penile penetration in the " missionary position" , most of the pressure (and trauma) is delivered to the lower part of the bladder (the so called neck of the bladder) and the upper portion of the urethra (which is about half way between the urethral orifice and the uterine cervix).
At the time of sexual arousal, the mucose membrane of the urethra and bladder become engorged, as will the entire vulvar-vaginal mucosa. At the time of intercourse, the engorged mucose membrane may pop and break up. Urine that leaks under the ruptured mucose membrane into highly sensetive sub-mucouse layer will produce an intense burning sensation, urgency and lasting pain at the end of urination - so called terminal dysuria - that is always diagnosed and treated as a bacterial infection. By the way, that is why in many cases you may discover a few drops of blood coming from the urethra or even bloody urine shortly after intercourse! This is known as " Honeymoon" cystitis, which is actually better defined as post-coital traumatic dysuria. It is not an infectious disease; it must instead be viewed as trauma. Using antibiotics in these cases is no better than using a placebo. That is why the treatment should be different...!
Please contact my office to schedule an appointment if you have these symptoms and would like the correct answer.
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