Causes of painful urination in children

Painful urination or in medical terms 'dysuria' can present as pain, burning or as a stinging feeling. It's more common in girls than in boys, but the condition could be more towards a infection in the boys.

Since the children below two years of age are less likely to complain about a urine pain, the parents should be vigilant of a small child who cries or finds it difficult to pass urine.

In certain instances, the pain would make the child wet more times than usual which is known as 'frequency' and is also unable to hold on to the urine in a condition known as 'urgency'. These symptoms can associate with urinary pain or can be the presentation of painful urination in very small children.

Apart from the above mentioned symptoms, it is possible for the child to have fever, vomiting, reduced feeding, and blood with the urine or haematuria associated with the pain.

When considering the causes for painful urination in children, following are highlighted.

Vulvo-vaginitis:

In girls, it is thought to be the number one cause for painful urination and the condition is an inflammation of the vulva and the enclosing mucosa. The vulva and the mucosa will appear red and sometimes even itching. The condition is said to be precipitated by irritation, most often due to 'soap water'. Bubble baths have shown to be responsible for much of these events.

Proper washing with clean water have found to be useful in preventing the condition and baking soda soaks are useful in the removing of irritant and relieving the pain.

Urinary tract infections:

Infection in the urethra, bladder or the kidneys can present as painful urination. Although in small children the infection might only be associated with fever or poor feeding. This could be one of the commonest causes for painful urination in boys and should be investigated and treated promptly due to the damage it can cause to the kidneys.

Trauma:

Any kind of trauma either self inflicted or following child abuse can lead to painful urination and should be investigated thoroughly.

Labial adhesions:

It is possible that the two labia can stick following an inflammatory reaction or from birth. If so, it should be gently moved apart and certain instances it may be necessary to apply a steroidal cream for number of days.

Foreign bodies:

It is possible that a foreign body, e.g. piece of toilet paper, can remain in the vulva and lead to irritation followed by a inflammatory reaction.

Apart from these, when there is no obvious cause to be found, parents should be vigilant about any associated events. Child abuse and worm infections are possibilities in children who complain of this condition.