Persistent Pain After Pediatric Urinary Tract Infection Recovery

Urinary tract infection (UTI)

My daughter is over 3 years old.
A little over a week ago, she had a urinary tract infection (caused by E.
coli) and was on antibiotics for a week.
After a follow-up check, it was confirmed that there were no bacteria and no blood in her urine.
However, she still experiences pain while urinating, which usually occurs when she first wakes up or after holding it for a longer period.
The doctor advised her to drink more water.
Could you please explain why she is still experiencing pain? Is it because the injury hasn't healed yet, or could there be other reasons? I'm a bit worried.
I've been giving her plenty of water, and her urine appears to be clear.
Thank you!

Ms. Chen, 30~39 year old female. Ask Date: 2011/03/11

Dr. Xiao Kaiwen reply Pediatrics

The vast majority of urinary tract infections (UTIs) are simple and uncomplicated infections, which can typically be effectively treated with antibiotics for 5 to 7 days.
However, in cases of more severe and complicated infections (such as those that have ascended to the upper urinary tract), the treatment duration may need to be extended to up to two weeks.
Routine urinalysis can detect over 90% of infections, but there are some cases, less than 10%, where routine urinalysis may not reveal the infection.
In such instances, a more detailed "urine culture" performed in a hospital is necessary to accurately determine the presence of bacteria in the urine.
If bacteria are still cultured, a sensitivity test can be conducted to provide the most effective antibiotic treatment.

Reply Date: 2011/03/11

More Info

Persistent pain after a urinary tract infection (UTI) in children, even after the infection has been treated, can be concerning for parents. In your daughter's case, it appears that she had a UTI caused by E. coli, which is a common pathogen in such infections. After a week of antibiotic treatment, her follow-up tests showed no bacteria or blood in her urine, indicating that the infection has been resolved. However, the lingering pain during urination can be attributed to several factors.

Firstly, it is important to understand that the urinary tract, including the bladder and urethra, can become inflamed during an infection. This inflammation may take some time to fully resolve, even after the bacteria have been eliminated. The tissues in the urinary tract can remain sensitive and irritated, leading to discomfort or pain during urination. This is particularly true if your daughter is experiencing pain primarily when she first wakes up or after holding her urine for an extended period. The bladder may still be sensitive, and the act of urination can trigger discomfort as the bladder contracts.

Secondly, the sensation of pain or discomfort can also be related to bladder overactivity or bladder spasms, which can occur after a UTI. These spasms can cause a feeling of urgency or pain when urinating, even in the absence of an active infection. Encouraging your daughter to drink plenty of fluids is a good strategy, as it helps dilute the urine and may reduce irritation in the bladder.

Another possibility is that your daughter may be experiencing a condition known as "post-infectious dysuria," where pain persists after the infection has cleared. This can be due to residual inflammation or irritation of the urinary tract. In some cases, children may also develop a fear of urination due to the pain experienced during the infection, which can lead to holding urine longer and exacerbating discomfort.

It is also worth considering other potential causes of urinary pain, such as vulvovaginitis in young girls, which can cause discomfort during urination. This condition is often due to irritation from soaps, bubble baths, or even tight clothing.
Given your daughter's symptoms, it would be advisable to follow up with her pediatrician or a pediatric urologist. They may recommend further evaluation to rule out any underlying issues, such as bladder dysfunction or anatomical abnormalities. In some cases, a referral for a bladder ultrasound or a voiding cystourethrogram (VCUG) may be warranted to assess the urinary tract's structure and function.

In summary, while it is common for children to experience lingering discomfort after a UTI, it is essential to monitor the situation closely. Encouraging hydration, maintaining good hygiene, and following up with healthcare providers will help ensure that any persistent symptoms are appropriately addressed. If the pain continues or worsens, further investigation will be necessary to determine the underlying cause and appropriate treatment.

Similar Q&A

Unexplained Urethritis: Persistent Pain and Discomfort Solutions

Hello Dr. Wang, I have experienced a burning sensation during urination and pain at the urethral opening three times in the past two months. However, each time I have undergone urinalysis, the results have been normal, and no infection has been identified, yet I continue to exper...

Dr. Wang Weijie reply Internal Medicine
Dear Ms. Wu, Thank you for your letter. A urinary tract infection (UTI) occurs when bacteria invade the urinary system, leading to infection. Common symptoms include: 1. A burning sensation, pain, difficulty urinating, frequent urination, nocturia, cloudy urine, or hematuria dur...

Understanding Painful Urination in Children: Causes and Solutions

Hello Doctor: My child, Youyou, has recently been experiencing pain when urinating. He tends to touch his genital area and makes some sounds indicating discomfort, especially at night when the pain seems to be worse. He often cries and only urinates a small amount before stopping...

Dr. Gu Qingxian reply Pediatrics
The urine test showed no significant findings, but there is pain during urination, which is likely a urinary tract infection. If it were a bladder infection, the frequency of urination would increase. It is advisable to wait for a while and check the urine again for better refere...

Understanding Pediatric Urinary Tract Infections: When to Seek Further Testing

Dear Doctor Tu, My son is currently 3 and a half years old. In early August, he had a urinary tract infection, and the urinalysis showed a count of 6000 bacilli. He has been on medication for 7-10 days. During a follow-up visit, an ultrasound revealed that he has urinary retenti...

Dr. Tu Xiuhong reply Urology
Hello: Please take your child to the hospital to check if the urinary tract infection has been resolved. Then we can decide if further tests are needed. Thank you!

Understanding Recurrent Urinary Tract Infections After Cystitis Treatment

Is it common to experience recurrent acute cystitis after recovery from an initial episode? About four weeks ago, I visited a healthcare clinic due to symptoms such as blood clots in urine and frequent urination, along with painful urination. The doctor diagnosed me with acute cy...

Dr. Liu Jianting reply Urology
Acute cystitis can be very uncomfortable, but successful treatment does not guarantee that it won't recur, especially for women who are more susceptible to infections due to their anatomical structure. It's important to consult a physician if you experience any discomfo...