Many children have trouble with urination.  Sudden accidents in a previously potty-trained child could be a behavior problem, or sign of illness - such as infection or diabetes.  Painful urination can be from infection or rashes or trauma to the area.

Also ask your child about bowel movements (hard, watery, painful, frequency, etc.) if you notice urine problems.  Constipation is associated with both accidents and infrequent urination.  Diarrhea can irritate the skin and cause pain with both urination and bowel movements.  Teach proper wiping techniques... many girls wipe front to back, leading to problems with the urinary tract.

Urinary tract infections:

Symptoms of infections of the urinary tract might include fever, vomiting, abdominal pain, frequent urination, accidents, foul smell to the urine, and pain with urination.  Not all symptoms need to be present.  It is diagnosed with a urine sample.  If a child is not able to provide a sample, our nurses can put a catheter in the urethra (the part of the body urine passes through when we urinate) and collect a sample.  Our office can do a quick urinalysis, which can help with proper diagnosis.  A sample with blood cells, proteins or nitrates can help us determine the cause.  If an infection is suspected, the sample will be cultured at a local laboratory.  Results of this culture are available in 2-3 days.  Antibiotics are used to treat infections of the urinary tract.  Children with multiple urinary tract infections, or young infants with their first infection, undergo further testing to determine their risk for future serious infections.  Click here for more information on this testing.

Other painful urination:

Not all painful urination is an infection.  We commonly see skin irritation as a cause for pain.  Improper wiping in newly potty trained girls is a common cause of painful irritation.  Soaps and bubble baths also irritate the sensitive genital skin in girls.  If the skin is red and irritated and there are no other symptoms of infection, home treatment is recommended.  You can have your child sit in a bath with warm water and 1 cup of baking soda.  No soaps should be used during this bath, as soaps can irritate the sensitive genital skin.  If hair washing is required, this can be done at the end of the bath, followed by rinsing of the genitals with fresh water.  This procedure can be repeated for all baths if it is a recurrent problem.  Applying petrolatum jelly or diaper rash ointment is also helpful.  See also our Vaginal Irritation Page.  If this treatment fails or symptoms worsen, an appointment is indicated.

Frequent urination:

Frequent urination can be a sign of diabetes.  It can also be due to constipation or infection with certain viruses (such as adenovirus).  Children with signs of increased thirst, increased hunger, weight loss, frequent urination (especially if there are other signs of dehydration, such as dry mouth, loss of tears or lethargy) need to be seen immediately.  A urinalysis in our office might show sugar, and a confirmatory blood test can help with diagnosis.  This is often a medical emergency and should be addressed as soon as symptoms are noticed.  Children with new diabetes are referred to an endocrinologist, a specialist in diabetes.  They often spend a few days in the hospital for stabilization of medical issues and teaching of how to manage at home.

If you are uncertain about the cause of problems with urination, call our office for an appointment.