Urinary Problems and Injuries, Age 12 and Older

Topic Overview

The urinary system

Most people will have some kind of urinary problem or injury in their lifetime. Urinary tract problems and injuries can range from minor to more serious. Sometimes, minor and serious problems can start with the same symptoms. Many urinary problems and injuries are minor, and home treatment is all that is needed to relieve your symptoms.

See pictures of the female urinary system and male urinary system.

Urine color and odor

Many things can affect urine color, including fluid balance, diet, medicines, and diseases. How dark or light the color is tells you how much water is in it. Vitamin B supplements can turn urine bright yellow. Some medicines, blackberries, beets, rhubarb, or blood in the urine can turn urine red-brown.

Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor. A sweet, fruity odor may be caused by uncontrolled diabetes. A urinary tract infection (UTI) can cause a bad odor.

Urinary symptoms

Common symptoms of a urinary problem include:

  • Burning with urination (dysuria). This is the most common symptom of a urinary tract infection.
  • Frequent urge to urinate without being able to pass much urine (frequency).
  • Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.
  • Fever.
  • Urgent need to urinate (urgency).
  • Feeling like you can't completely empty your bladder.
  • Blood in the urine (hematuria). Your urine may look red, brown, or pink. Blood in the urine may occur after intense exercise, such as running or bicycling.
  • Leaking urine (incontinence).
  • Nausea and vomiting.

When you only have one symptom or if your symptoms are vague, it can be harder to figure out what the problem is. If you are slightly dehydrated, your urine will be more concentrated, and urinating may cause discomfort. Drink more fluids—enough to keep your urine light yellow or clear like water—to help decrease discomfort.

Urinary tract infections

When you have a urinary tract infection (UTI), you may have several urinary symptoms. UTIs are more common in women than in men. This is because the urethra is shorter in women and comes into contact with bacteria from the skin, anus, and vagina. You can reduce your chance of having a UTI by controlling risk factors that can cause these infections.

Infections that commonly cause UTI symptoms include:

Other urinary problems

Kidney stones are another urinary problem that can cause mild to severe urinary symptoms. Men ages 20 to 30 are affected most often with kidney stones, but anyone can get stones at any age. For more information, see the topic Kidney Stones.

An injury to the genital area can cause severe pain. The severity of the pain is not always an indicator of the severity of the injury. After an injury such as a hit to the genital area, it is important to watch for urinary problems. You usually need to see your doctor if you are having trouble urinating, can't urinate, have blood in your urine, have swelling, or have ongoing pain.

In women and girls, genital skin irritation can cause pain with urination.

Urinary problems related to aging

As people age, some urinary problems become more common. Stress incontinence is the most common form of urinary incontinence in older women. Multiple childbirths, aging, and decreasing hormone levels may cause changes in the pelvic muscles and supportive structures that lead to stress incontinence. It may also occur in men, especially those who have had prostate surgery. For more information, see the topic Urinary Incontinence in Women or Urinary Incontinence in Men.

In men, trouble urinating or the inability to urinate is often caused by prostate enlargement. For more information, see the topic Benign Prostatic Hyperplasia (BPH).

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have problems with urination?
Yes
Problems with urination
No
Problems with urination
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Did the urinary symptoms begin after an injury?
An injury could be from a blow to the belly, groin, or lower back (the kidney area).
Yes
Symptoms began after an injury
No
Symptoms began after an injury
Did the injury happen within the past 2 weeks?
Yes
Injury within past 2 weeks
No
Injury within past 2 weeks
Is there any blood in your urine?
Yes
Blood in urine
No
Blood in urine
Are you having trouble urinating?
Yes
Difficulty urinating
No
Difficulty urinating
Are you able to urinate at all?
Yes
Able to urinate
No
Unable to urinate
On a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine, how bad is the pain that comes from not being able to urinate?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has it been more than 12 hours since you were last able to urinate?
Yes
More than 12 hours since last able to urinate
No
More than 12 hours since last able to urinate
Do you have pain on one side of your back, just below your rib cage?
This is called flank pain. It sometimes is a symptom of a problem with the kidneys.
Yes
Flank pain
No
Flank pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Have you recently started having new or worsening pain when you urinate?
Yes
Pain when urinating
No
Pain when urinating
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Have you had pain while urinating that has lasted more than a day?
Yes
Pain when urinating has lasted more than 1 day
No
Pain when urinating has lasted more than 1 day
Within the past couple of weeks, have you started having a more frequent urge to urinate?
You may notice that even though you have the urge to urinate, there's not much urine when you try to urinate.
Yes
Urinary urgency
No
Urinary urgency
Severe (very uncomfortable)
Urinary urgency is severe and very uncomfortable
Moderate to mild (somewhat uncomfortable)
Urinary urgency is noticeable but not severe
Has this frequent urge to urinate lasted more than a day?
Yes
Urinary urgency for more than 1 day
No
Urinary urgency for more than 1 day
Are you nauseated or vomiting?
Nauseated means you feel sick to your stomach, like you are going to vomit.
Yes
Nausea or vomiting
No
Nausea or vomiting
Do you have only one kidney or a Foley catheter in place?
Yes
One kidney or a Foley catheter
No
One kidney or a Foley catheter
Do you think that the urinary problem may have been caused by abuse?
Yes
Urinary problem may have been caused by abuse
No
Urinary problem may have been caused by abuse
Do you have diabetes?
Yes
Diabetes
No
Diabetes
Is your diabetes getting out of control because you are sick?
Yes
Diabetes is affected by illness
No
Diabetes is affected by illness
Do you and your doctor have a plan for what to do when you're sick?
Yes
Diabetes illness plan
No
Diabetes illness plan
Is the plan helping get your blood sugar under control?
Yes
Diabetes illness plan working
No
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Did you take your temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long have you had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
At least 2 days but less than 1 week
Fever for at least 2 days but less than 1 week
1 week or more
Fever for 1 week or more
Do you have a health problem or take medicine that weakens your immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Do you have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Have you been urinating a lot more than usual for no clear reason?
An unexplained increase in urination can be an early symptom of diabetes.
Yes
Unexplained increase in urination
No
Unexplained increase in urination
Yes
Other diabetes symptoms
No
Other diabetes symptoms
Do you think that a medicine may be causing the urinary problems?
Think about whether the problems started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing urinary symptoms
No
Medicine may be causing urinary symptoms
Are you having new or worsening problems with bladder control or leaking urine for longer than 1 week?
Yes
Urinary incontinence for longer than 1 week
No
Urinary incontinence for longer than 1 week
Have the urinary problems lasted for more than a week?
Yes
Urinary problems for more than 1 week
No
Urinary problems for more than 1 week

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of diabetes may include:

  • Increased thirst and more frequent urination, especially at night.
  • An increase in how hungry you are.
  • Losing or gaining weight for no clear reason.
  • Unexplained fatigue.
  • Blurred vision.

A severe urgency problem means that:

  • You are uncomfortable most of the time.
  • You get the urge to go again right after you have just urinated.
  • The problem interferes with your daily activities.
  • The urge keeps you from sleeping at night.

A moderate or mild urgency problem means that:

  • The urge to urinate comes more often than you are used to, but it is not constant.
  • It does not interfere much with your daily activities.
  • It usually does not keep you from sleeping.

It is easy for your diabetes to become out of control when you are sick. Because of an illness:

  • Your blood sugar may be too high or too low.
  • You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
  • You may not know how to adjust the timing or dose of your diabetes medicine.
  • You may not be eating enough or drinking enough fluids.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Urinary Problems and Injuries, Age 11 and Younger

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
Pregnancy-Related Problems

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

If you're not sure if a fever is high, moderate, or mild, think about these issues:

With a high fever:

  • You feel very hot.
  • It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.

With a moderate fever:

  • You feel warm or hot.
  • You know you have a fever.

With a mild fever:

  • You may feel a little warm.
  • You think you might have a fever, but you're not sure.

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target range is.
  • Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
  • What to do if you have trouble keeping food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Many prescription and nonprescription medicines can cause urinary symptoms. A few examples include:

  • Antihistamines.
  • Decongestants.
  • Opiate pain medicines.
  • Tricyclic antidepressants.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

  • High: 104 °F (40 °C) and higher
  • Moderate: 100.4 °F (38 °C) to 103.9 °F (39.9 °C)
  • Mild: 100.3 °F (37.9 °C) and lower

Ear or rectal temperature

  • High: 105 °F (40.6 °C) and higher
  • Moderate: 101.4 °F (38.6 °C) to 104.9 °F (40.5 °C)
  • Mild: 101.3 °F (38.5 °C) and lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate: 99.4 °F (37.4 °C) to 102.9 °F (39.4 °C)
  • Mild: 99.3°F (37.3°C) and lower

Home Treatment

Bladder infections

Starting home treatment at the first minor signs of a bladder infection may prevent the problem from getting worse, clear up your infection, and prevent complications.

  • Drink more fluids—enough to keep your urine light yellow or clear like water—as soon as you notice the symptoms and for the next 24 hours. This will help dilute the urine, flush bacteria out of the bladder, and decrease irritation. Note: If a medical condition such as a kidney or heart problem prevents you from drinking more fluids, make sure you are drinking your usual amount of fluids. Drinking cranberry juice may reduce the chances of having urinary tract infections.
  • Urinate when you feel the urge. Don't wait until a more convenient time.
  • Do not drink alcohol, caffeine, and carbonated beverages, which can irritate the bladder.
  • Take a warm bath, which may help relieve pain and itching.
    • Avoid using bubble bath, because it may cause more irritation. If urinary pain or vaginal burning and redness occur in a young girl, she may have an allergy to bubble bath or soap.
    • Use gentle soaps, such as hypoallergenic soaps. Avoid deodorant soaps. Use as little soap as possible.
  • Apply a heating pad over your genital area to help relieve the pain. Set the heating pad temperature on low. Never go to sleep with a heating pad in place.
  • Examine your genital area. Increased redness may mean skin irritation.
  • Wear loose clothing and soft cotton underwear. Do not use soaps, perfumes, or feminine hygiene sprays on the genital area.
  • Avoid intercourse until symptoms improve. Do not use a diaphragm or spermicidal cream, foam, or gel. A diaphragm may put pressure on your urethra. This pressure may slow down or prevent your bladder from emptying completely. Spermicides can cause genital skin irritation.

Recurrent bladder infections in women

If you have frequent bladder infections without complications, you and your doctor may develop a self-treatment plan. The plan usually includes taking antibiotics at the first sign of a bladder infection. Contacting your doctor is not necessary. For more information, see the topic Urinary Tract Infections in Teens and Adults.

If you are certain that your symptoms are caused by a bladder infection, follow your doctor's instructions for taking the medicine and monitoring your symptoms. Keep a diary of the number of times you use your self-treatment plan. Call your doctor if:

  • Your symptoms do not improve after 48 hours of treatment.
  • You start having bladder infections more often than in the past.

Your self-treatment plan is developed for your health needs. Do not take antibiotics that have not been specifically prescribed for this bladder infection. Do not take antibiotics left over from a previous prescription or antibiotics prescribed for someone else.

Urinary incontinence

Urinary incontinence is common, especially among older adults. Home treatment can often help decrease your symptoms.

  • Talk to your doctor about your incontinence at your next regularly scheduled appointment.
  • Reduce the amount of fluids you drink to no more than 2 qt (2 L) daily.
  • Establish a schedule of urinating every 2 to 4 hours, whether you feel the need or not.
  • Make a clear, quick path to the bathroom, and wear clothes that you can easily remove, such as ones with elastic waistbands or Velcro closures. Keep a bedpan or urinal close to your bed or chair.
  • Practice "double voiding" by urinating as much as possible, relaxing for a few moments, and then urinating again.
  • Do not drink caffeinated or carbonated beverages, such as caffeinated coffee, tea, and soda.
  • Do not drink more than 1 alcohol drink a day.
  • Increase the amount of fiber in your diet. Constipation may make your symptoms worse. For more information, see the topic Constipation, Age 12 and Older.
  • Talk with your pharmacist or doctor about all medicines you take, including nonprescription medicines, to see whether any of them may be making your incontinence worse.
  • Strengthen your pelvic muscles by doing Kegel exercises every day and by having a regular exercise program.
  • Control your weight. If you are overweight, try to lose some weight. Remember that effective weight-loss programs depend on a combination of diet and exercise. For more information, see the topic Weight Management.
  • Quit smoking or using other tobacco products. This may reduce the amount that you cough, which may reduce your problem with incontinence. For more information, see the topic Quitting Smoking.

Home treatment for other urinary problems

For information about home treatment for other urinary problems, see the following:

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Other symptoms develop, such as fever, belly pain, or vomiting.
  • You are unable to urinate or have increasing difficulty urinating.
  • Symptoms of a bladder infection do not completely go away after home treatment.
  • More urinary symptoms develop, such as localized back pain (flank pain) or blood in your urine.
  • Symptoms become more severe or more frequent.

Prevention

You can help prevent urinary problems by following these tips:

  • Drink more fluids, enough to keep your urine light yellow or clear like water. Water and cranberry juice are good choices. Extra fluids help flush the urinary tract. Note: If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Do not drink alcohol, caffeine, and carbonated beverages, which can irritate the bladder.
  • Urinate frequently. Urinate whenever you have the urge.
  • Wash the genital area once a day with plain water or mild soap. Rinse well and dry thoroughly.
  • Increase the amount of fiber in your diet. Constipation may make your symptoms worse. For more information, see the topic Constipation, Age 12 and Older.

The following tips can help women prevent urinary symptoms:

  • Wipe from front to back after using the toilet. This may reduce the spread of bacteria from the anus to the urethra.
  • Do not take bubble baths or use perfumed soaps or powders in the genital area. These products may cause genital skin irritation.
  • Do not douche, and do not use vaginal deodorants or perfumed feminine hygiene products.
  • Wear cotton underwear, cotton-lined panty hose, and loose clothing. This helps promote the circulation of air to the vaginal area.
  • Change sanitary napkins often.
  • Drink extra water before intercourse, and urinate promptly afterward. This is especially important if you have had many urinary tract infections.
  • Do not use a diaphragm or spermicidal cream, foam, or gel. A diaphragm may put pressure on your urethra. This pressure may slow down or prevent your bladder from emptying completely. Spermicides can cause genital skin irritation. For more information on methods of birth control, see the topic Birth Control.

For information about preventing kidney stone formation, see the topic Kidney Stones.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • How long have you had your symptoms?
  • What are your symptoms? Have you had:
    • Pain or burning upon urination?
    • An urge to urinate frequently, but you usually pass only small quantities of urine?
    • Dribbling (inability to control urine release)?
    • Reddish or pinkish urine?
    • Bad-smelling urine?
    • Cloudy urine?
  • Have you had a fever?
  • Have you had flank or belly pain?
  • Have you had nausea or vomiting?
  • Have you had vaginal or penile discharge or itching? Do you have a new sex partner, or do you practice high-risk sexual behavior?
  • Have you ever had a problem like this in the past? If so, when? How was it treated?
  • What do you think may have triggered this episode?
  • Have you had a recent injury to the belly, pelvis, or back?
  • What home treatments have you tried, and how effective were they?
  • Do you have any health risks?

Remember that a urine specimen will probably be collected during your office visit. Try not to urinate immediately before the visit.

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
Last Revised November 3, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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