Definition

• Pain, burning or stinging when passing urine
• Suspect pain if a young child starts to cry while passing urine
• The feeling of "can’t wait" to pass urine may occur. This is called urgency.
• Passing small amounts of urine at a time may also occur. This is called frequency.

Health Information

Causes

• Soap vulvitis. In young girls, soap in the bath water is the main cause. This includes bubble bath and shampoos in the bath water. Soaps can cause the genital area to become red and sore. This is also called "chemical vulvitis". It can cause pain when passing urine. Using a soapy washcloth can also be the cause. Vaginal itching can also occur from soap.
• Bladder or kidney infections (urinary tract infections) are possible at any age.
• STD. In teenagers, pain when passing urine can be from diseases spread during sex.
• Vaginitis. A vaginal infection with a yellow-colored discharge. It can irritate the opening to the urethra. In young girls the most common cause of vaginal discharge is Strep bacteria.

Diagnosis

• A urine sample needs to be checked to make the correct diagnosis.

Care Advice

1. Overview:
   • Pain with passing urine is never normal.
   • In young girls, soap is the most common cause of pain with passing urine.
   • To rule out a bladder infection, the urine needs to be checked.
   • Until a urine test is done, here is some care advice that should help.
2. Baking Soda Baths - Young Girls Only:
   • Soak for 10 minutes to remove germs and to help with healing.
   • Add 2 ounces (60 ml) baking soda per tub of warm water.
   • Reason: Baking soda is better than vinegar for young girls.
   • During soaks, be sure she spreads her legs. This allows the water to cleanse the genitals.
   • Repeat baking soda soaks 2 times per day for 2 days.
3. Do Not Use Soaps - Young Girls Only:
   • Do not use bubble bath, soap and shampoo in the bath water. They can cause the genitals to be red, sore or itchy. This is the most common cause of pain with passing urine in young girls.
   • Only use warm water to cleanse the genitals.
   • Baby oil can be used to remove any dried body fluids.
   • After puberty, soap can be used.
4. Give More Fluids:
   • Give extra fluids to drink.
   • Reason: Dilutes the urine so that it does not sting.
5. Pain Medicine:
   • For pain when passing urine, give a pain medicine.
   • Give acetaminophen (such as Tylenol) or ibuprofen.
   • Use as needed.
6. What to Expect:
   • If soap is the cause, the pain should go away within 24 hours.
   • Itching or skin redness may last 2 days.
7. Return to School:
   • Even if your child has a bladder infection, it cannot be spread to others.
   • Your child does not need to miss any school or child care.

Call Your Doctor If

• Pain when passing urine becomes severe
• Fever occurs
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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