Urination Pain

Pediatric HouseCalls Online

DEFINITION

• Discomfort (pain, burning or stinging) when passing urine.
• In children too young to talk, suspect pain if your child begins to cry regularly while passing urine.
• Urgency (can't wait) and frequency (passing small amounts) of urination may be associated symptoms 

Causes

• Main cause in young girls: an irritation and redness of the vulva and opening of the urethra from bubble bath, shampoo or soapy bath water (soap vulvitis)
• Any boy with painful urination needs his urine checked. Occasionally in young boys the urine is normal and the pain is caused by an irritation of the opening of the penis.  In teenage boys, pain can be due to inflammation of the urethra caused by a sexually transmitted disease.
• Bladder or kidney infections (urinary tract infections) are possible at any age.

Return to School

• Even if your child has a bladder infection, it is not contagious. Your child does not need to miss any school or daycare.

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Can't pass urine or only can pass a few drops
• Blood in urine
• Severe pain with urination
• Fever is present
• Abdominal, side or back pain

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• Painful urination, but none of the symptoms described above (probably soap vulvitis in girls).

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HOME CARE ADVICE FOR SOAP VULVITIS (pending talking with your doctor)

1. Definition:  Soap Vulvitis is the #1 cause of pain with urination in young girls
   • Burning or stinging with passing urine.
   • Vaginal itching or irritation may also be present.
   • Prepubertal girl less than 10 years old.
   • Uses bubble bath, bathes in soapy water or washes genitals with soap.
   • To be sure she doesn't have a bladder or kidney infection, she usually needs to have her urine checked.  The following treatment will reduce symptoms while awaiting your appointment.
2. Baking Soda-Warm Water Soaks:  
   • Soak for 20 minutes to remove irritants and to promote healng.
   • Add 2 oz. baking soda per tub of warm water (Reason: baking soda is better than vinegar for girls not into puberty).
   • During soaks, be sure she spreads her legs and allows the water to cleanse the genital area. 
   • Repeat baking soda soaks treatment 4 times per day for 2 days.
3. Avoid Soaps:   Avoid bubble bath, soap and shampoo to the vulva because they are irritants.  Only use warm water to cleanse the vulva or baby oil to remove secretions.
4. Increased Fluids:   Give extra fluids to drink (Reason: to produce a dilute, nonirritating urine).
5. Pain Medicine: To reduce painful urination, give acetaminophen every 4 hours (See Dosage table) OR ibuprofen every 6 hours as needed (See Dosage table).
6. Contagiousness:  Even if your child has a bladder infection, it is not contagious.Your child does not need to miss any school or daycare.
7. Call Your Doctor If:
   • Your child becomes worse
   • Fever occurs
   • Your child becomes worse

And remember, contact your doctor if you child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 12/19/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.