Health Library Urinary Problems and Injuries, Age 12 and OlderFrom Healthwise

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.

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).
• Urgent need to urinate (urgency).
• Feeling like you cannot completely empty your bladder.
• Blood in the urine (hematuria). Your urine may look red, brown, or pink. Blood in the urine may occur after exercise, such as running or bicycling.
• Leaking urine (incontinence).

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:

• Bladder infections, which are the most common type of UTI, and occur most often in sexually active women between the ages of 20 and 50. An estimated 50% of women develop bladder infections sometime during their lives.
• Kidney infections, which are less common and more serious than bladder infections.
• Prostatitis and epididymitis. These are urinary tract problems that are common in men. For more information, see the topics Prostatitis and Epididymitis.
• Urethritis, which can occur with sexually transmitted diseases (STDs), causing pain with urination. For more information, see the topic Exposure to Sexually Transmitted Diseases.

Other urinary problems

Kidney stones are another urinary problem that can cause mild to severe urinary symptoms. Men between the ages of 20 and 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. Usually the pain subsides over the course of a few minutes to an hour. 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 health professional if you are having trouble urinating, cannot 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, the inability to urinate is often caused by prostate enlargement. For more information, see the topic Benign Prostatic Hyperplasia (BPH).

Review the Check Your Symptoms section to determine if and when you need to see a health professional.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

	Yes	Are you unable to urinate?
When to See a Doctor See significance of inability to urinate if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you have not urinated for several hours but are not having pain, look for signs of dehydration. For more information, see the topic Dehydration. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have mild to moderate pain? Yes Have you been unable to urinate for 12 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Has your trouble urinating come on gradually? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did your urinary symptoms begin after an injury?
When to See a Doctor See significance of urinary symptoms after an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Are you unable to urinate? Yes Do you have blood in your urine? Yes Do you think that your inability to urinate was caused by abuse? Call your health professional today if you answer "Yes" to the following question. Yes Are you having trouble urinating? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have symptoms of a kidney infection?
When to See a Doctor See significance of symptoms of a kidney infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have continuous, severe flank pain? Yes Are you pregnant? Yes Do you have diabetes? Yes Do you have a medical condition or take a medicine that affects the immune system? Yes Do you have only one kidney? Yes Do you have a Foley catheter in place? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have continuous, moderate flank pain? Yes Do you have a fever? Yes Do you have burning with urination? Yes Do you have to urinate frequently, but you are not able to pass much urine? Yes Do you have nausea or vomiting? Yes Do you have cloudy or bad-smelling urine? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had continuous mild flank pain for 24 hours or longer, but you do not have other symptoms? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Do you have flank pain that comes and goes (intermittent), but you do not have other symptoms? Yes Do you have vague urinary symptoms that have been evaluated by a health professional but are not following the expected course? Yes Have you had vague urinary symptoms for 1 week or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have symptoms of a bladder infection?
When to See a Doctor See significance of symptoms of a bladder infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have severe pain when you urinate? Yes Are you pregnant? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have moderate pain when you urinate? Yes Do you have a frequent urge to urinate but cannot urinate at all or are passing only small amounts of urine? Yes Do you have blood in your urine? (Your urine may look pink, red, or brown.) Yes Do you have nausea or vomiting? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you been urinating slightly more frequently and passing smaller amounts of urine than usual for 24 hours or longer after trying home treatment? Yes Have you had mild pain or burning during urination for 24 hours or longer after trying home treatment? Yes Have you had an urgent need to urinate for 24 hours or longer after trying home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Have you had vague urinary symptoms that have been evaluated by a health professional but are not following the expected course? Yes Have you had vague urinary symptoms for 1 week or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have urinary symptoms with a fever?
When to See a Doctor See significance of urinary symptoms with a fever if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you need information on how to take a temperature, see the topic Body Temperature. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have a fever of 104 °F (40 °C)or higher? Yes Do you think that you have a high fever, but you are unable to measure your temperature? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have a fever of 100 °F (37.8 °C)or higher? Yes Do you think that you have a mild fever, but you are unable to measure your temperature? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your urine cloudy, bad-smelling, or bloody?
When to See a Doctor See significance of urine that is cloudy, bad-smelling, or bloody if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain when you urinate? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have blood in your urine? (Your urine may look pink, red, or brown.) Yes Do you have a fever? Yes Do you have flank pain? Yes Do you have nausea or vomiting? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had cloudy or bad-smelling urine for 24 hours or longer without other symptoms? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had dark amber or brown urine for 1 week or longer without other symptoms? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have uncontrollable urine leakage (incontinence)?
When to See a Doctor See significance of uncontrollable urine leakage if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you ever leak urine, but you do not have a history of stress incontinence and you do not have other problems? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Have you had new, gradual incontinence after 1 week of home treatment? Yes Have you had repeated episodes of incontinence after 2 weeks of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Have you had increased urination without an obvious cause?
When to See a Doctor See significance of increased urination if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Are you younger than 18 years old and you have four of the following symptoms? Increased thirst and frequent urination, especially at night Unexplained increase in appetite Unexplained weight loss or weight gain Fatigue Blurred vision Tingling or numbness in your hands or feet You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Are you 18 years old or older and you have had four of the following symptoms? Note: If you have four or more of the following symptoms, your doctor may want to check you for diabetes. If you have had the symptoms for 2 weeks or longer, call your doctor to schedule an appointment in the next 2 to 3 days. Increased thirst and frequent urination, especially at night Unexplained increase in appetite Unexplained weight loss or weight gain Fatigue Erection problems Blurred vision Tingling or numbness in your hands or feet Yes Have you urinated more frequently and drunk more fluids for no apparent reason for the past 72 hours? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think your urinary problem may be caused by a medicine?
When to See a Doctor See significance of a medicine if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you think your urinary problem is caused by a medicine? Note: If you answered "Yes": Call the health professional who prescribed the medicine to determine whether you should stop taking it or take a different one. An appointment may not be necessary. If you are taking a nonprescription medicine, stop taking the medicine. Call your health professional if you feel you need to continue taking the medicine. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you still have urinary symptoms after taking antibiotics for 48 hours?
When to See a Doctor See significance of symptoms after 48 hours of antibiotic treatment if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Have your symptoms continued without improvement after 48 hours of antibiotic treatment for an infection? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• Discharge from the vagina or penis: Go to the topic Exposure to Sexually Transmitted Diseases.
• Abdominal pain: Go to the topic Abdominal Pain, Age 12 and Older or Abdominal Pain, Age 11 and Younger.
• Male genital problems: Go to the topic Male Genital Problems and Injuries.
• Vaginal problems: Go to the topic Vaginal Problems.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

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 additional irritation. If urinary pain or vaginal burning and redness occur in a young girl, consider the possibility of an allergy to bubble bath or soap.
  • Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay. 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 indicate 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 health professional may develop a self-treatment plan. The plan usually includes taking antibiotics at the first sign of a bladder infection. Contacting your health professional 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 health professional'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 health professional 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 health professional 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 alcoholic 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 health professional 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 Healthy Weight.
• 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 Tobacco Use.

Home treatment for other urinary problems

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

• For men who have symptoms of prostate enlargement, see the topic Benign Prostatic Hyperplasia (BPH).
• For men who have symptoms of prostate infection, see the topic Prostatitis.
• For new kidney stones, see the topic Kidney Stones.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms 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 get worse with the use of home treatment.
• Symptoms of a bladder infection do not completely go away after 48 hours of 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.

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 or cranberry or blueberry 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 afterwards. 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 information about preventing kidney stone formation, see the topic Kidney Stones.

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

You can help your health professional 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.

• Abdominal Pain, Age 12 and Older
• Back Problems and Injuries
• Bed-Wetting
• Benign Prostatic Hyperplasia (BPH)
• Chlamydia
• Constipation, Age 12 and Older
• Exposure to Sexually Transmitted Diseases
• Fever, Age 4 and Older
• Genital Herpes
• Gonorrhea
• Kidney Stones
• Male Genital Problems and Injuries
• Nausea and Vomiting, Age 4 and Older
• Pelvic Inflammatory Disease
• Prostatitis
• Urinary Incontinence in Men
• Urinary Incontinence in Women
• Urinary Tract Infections in Teens and Adults
• Vaginal Problems

Author:	Jan Nissl, RN, BS	Last Updated: May 17, 2007
Medical Review:	William M. Green, MD - Emergency Medicine Philip Belitsky, MD, FRCSC - Urology
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