Painful Urination and Its Causes

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Now that we are feeling the heat of summer, let’s discuss an issue common to the season. Dysuria, or painful urination, is a common complaint we hear during this time.

First, let’s discuss the anatomy of the urinary system. Urine is formed in the kidneys and travels down the ureters to be stored in the bladder. The bladder then empties through the urethra when you urinate. The issues discussed here are common to the urethra and bladder.

Generally, there are two potential causes of painful urination: 1. Infection, which is fully known as a urinary tract infection (UTI) and; 2. Chemical urethritis. The first requires an antibiotic to treat, while the second is caused by irritation, generating symptoms that are very similar to UTIs.

Symptoms of both UTIs and chemical urethritis can be frequent urination, painful urination (or dysuria), blood in the urine (or hematuria), urinary hesitation (feeling like you need to urinate but urinating very little or being unable to urinate). Distinctions between the two are that UTIs can be associated with fever and abdominal pain, whereas chemical urethritis can typically be associated with the area of the urethral opening have some redness or rash around it.

Urinary tract infections (UTI) are caused by bacteria which are present in the urethra or bladder. If severe enough, these bacteria can also be present in the ureters or kidneys. Diagnosis of a UTI requires a special urinary test, and treatment requires an antibiotic.

Urinary tract infections generally are treated with antibiotics. They are a simple infection to diagnose for children who are potty trained. Any child who is less than 2 years of age typically needs to be treated a little differently with regard to diagnosis and treatment. They may require a few more studies depending on the circumstances. Females are also more likely to have a diagnosed UTI versus boys. And uncircumcised boys are more likely to have a UTI than circumcised boys.

Chemical urethritis, on the other hand, is generally caused by irritation to the area of the urethra. Common causes of irritation are: 1. Baths (bubble baths and bath bombs are usually the greatest offender); 2. Lapses in hygiene, and; 3. Extended time in a wet bathing suit. Preventative measures include: 1. Switching over to showers, or waiting until the end of the bath to use any soap products and then getting out quickly; 2. Coaching your kids to wipe front to back, and then cleaning the area with water (but not soap); and 3. Changing over to dry clothes soon after swimming.

Regardless of the cause, painful urination can be addressed by your child’s pediatrician.  You now hopefully have a few more tools to help prevent your child from experiencing it in the first place.