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Painful urination (Dysuria)



  Children can have symptoms of stinging when they urinate.  It is called Dysuria and can be a sign of infection.  But 90% of the time it is just irritation caused by soaps and/or poor hygiene.  The kids become potty trained and want to go to the restroom by themselves.  Then they do not wipe or wrong direction.  You will go in there and they did not flush and there is no paper in the toilet.  The girls will have a little odor and periodic chafing which will cause occasional stinging when they urinate.  But the next time they urinate it does not.   That is not an infection.  A urine infection will cause all day long burning, frequency and accidents.  There can be some white cells in the urinalysis from irritation but the culture is what will prove infection.   Do not accept a urinalysis to diagnose urine infections… request a culture.  Also cleaning their private area too vigorously with chemical wipes can cause irritation.  Swimming a lot in the summer and riding trikes or bikes with the sweat and friction can cause irritation also.  After 2 years old I do not recommend baby soaps, fragrance soaps, or any products that causes bubbles on the surface of the water.  They remove the protective mucous lining of their privates.   Use Dove or Oil of Olay unscented bar of soap.  Put Vaseline or A&D ointment down there if it becomes chafed and if it is getting irritated every week, then put a thin coating of ointment down there after every bath.  It will be several years until they take better care of that area.  Males can be irritated also and especially if not circumcised.  Plus it is hard to potty train them if it hurts.  There is a condition called asymptomatic bacteriuria.   There are some bacteria in the bladder with no symptoms and does not need to be treated unless they have significant kidney problems or catheters.  So a doctor may culture the urine of a child with once a week urine stinging and treat it.  This probably is not a true infection but it does not hurt much to treat it.  Those bacteria may have been there for months.  Kind of like when a child has a mild sore throat and has a positive test for strep.  The strep could have been there for months and the child is a carrier.  If you have true strep throat you are acting ill and have fever.  So it sometimes is hard to decide if the occasional dysuria is from the positive urine culture.   

There is no good way to treat the symptom other than the ointment.  Cranberry will not help

Dr. Knapp