At least once a day a child comes in to my office complaining of pain with urination.  Parents think that their child has a urinary tract infection (UTI).  Although a UTI is a common cause of painful peeing, not all urinary pain is infectious in nature.

In babies, pediatricians will look for UTI as a possible cause of a fever or irritability.  Babies are screened for these infections by placing a plastic bag in their diaper area and catching a urine sample.  If this sample indicates a possible infection, then a cleaner specimen is obtained using a catheter.  In children who are potty trained, collecting urine in a cup is adequate and using a catheter is not necessary.  Babies diagnosed with a UTI, especially if associated with a fever, usually need further testing to evaluate and possibly eliminate recurrent infections.

School age boys rarely have UTI as their cause of painful peeing.  Male anatomy is very protective against these infections, although uncircumcised males do have a slightly greater risk.  Sometimes, pain is caused by irritation at the tip of the penis.  Sometimes, very concentrated urine might sting, which means the child needs to hydrate themselves better to relieve the discomfort.  Even though UTI is rare in school age boys, it is advised to bring your child to the doctor for exam and urine testing if he complains of urinary pain.

Girls are a whole different story.  A female’s anatomy makes girls very prone to UTI.  But again, not all painful urination is infection. For example, school age girls, and especially newly potty trained 3 and 4 year olds, do not maintain good hygiene in their vaginal areas.  This can lead to vaginal irritation and inflammation (vaginitis) and even vaginal infection.  Girls need to be constantly reminded to keep their private area clean, making sure to wipe from front to back after urination.  Also, bubble baths can irritate sensitive areas and I do not recommend them to girls.  During the summer months, chemicals in the pool can be irritating.  After swimming, make sure to shower off to decrease exposure to these chemicals.  To help with vaginal irritation, I recommend a sitz bath—a clean tub of tepid water with a small amount of baking soda—making sure to wash out the area well.

Remember, if your child complains of pain with urination, the way to diagnose and remedy the problem is to see your doctor for an examination and urine sample.

All information given is not a substitute for the advice of your pediatrician, primary care provider or trained health professional.  Always consult with your pediatrician or health care professional