Painful Urination – Not always from a Urinary Tract Infection

Painful urination (also called dysuria) is a common occurrence in children, but urinary tract infection (UTI) is often not the cause.  Understanding the signs and symptoms of a urinary tract infection as well as other common causes of painful urination can be helpful for parents.  

Some causes of painful urine in children include UTI, inflammation (vulva or vaginal in females, or penile/foreskin in males), dehydration, and kidney stones. 

Urinary tract infections are more common in girls than boys.  

Symptoms often include frequent or urgent urination, pain or burning when passing urine, avoiding or holding urination, urinary accidents, or lower abdominal pain.  In more severe infections nausea, blood in the urine, vomiting, back pain/tenderness, or fevers may occur.  

Initial treatment at home includes drinking lots of fluids.   

Tylenol can be used for pain in children of all ages.   Other urinary pain medications may also be recommended for children 12 and older. 

Most urinary tract infections require confirmation with a urinalysis and urine culture.  Treatment is usually prescription antibiotics once the diagnosis is confirmed.  

Soap vulvovaginitis is a common cause of painful urination in girls.  This is caused by inflammation around the vagina and urethra from chemicals such as soaps, bubble baths, or other perfumes or dyes that may be used, especially with bathing.  

Males can get similar inflammation/irritation to the urethra or foreskin from soaps and irritants.   

In these cases, the symptoms may be similar to a UTI but there is no infection present.  

Treatment is to remove the irritant causing inflammation and drinking lots of fluids (especially water).  Your doctor may also recommend baking soda soaks to help soothe the inflammation.  

External infections with yeast or bacteria may also have dysuria.   They will usually also have redness or irritation around the external vagina or penis.  Topical or oral ant-yeast or antibiotic medications may be needed in these cases.  

Kidney (also called Renal) Stone, while uncommon in children, often present with painful urination.   

Other symptoms include severe and sharp pains in the back, lower abdomen, or groin, constant feeling of needing to urinate, pink or red tinged (from blood) urine, or inability to pass urine.  

Nausea, vomiting, or fever may also be present.  

Call your child’s pediatrician if your child has signs of a UTI and always seek evaluation if severe pain, vomiting, or fever accompany any other urinary symptoms.