I get a foul smell in my urine and pain during urination. Why?

Question

Hello doctor,

I am a 17-year-old male. My urine smells very strong and foul. This issue has been present for months, and I have been to the doctor regarding this.

If I had to describe the smell, I would say that it smells like a can of Vienna sausages, a terrible smell. After urinating, this smell will be from the toilet itself and will sometimes follow me for 20-30 seconds after leaving the room.

Currently, I am drinking around a gallon of water a day to ensure that it is not due to dehydration.

Previously, I have been to the doctor three times on this issue. They did a urine culture to test for UTI, blood tests (presumably to test for STDs/high calcium levels). Everything came back negative.

I am also facing constant pain in the ribs and the back (I have bad posture). While urinating, it feels like something is trying to escape my bladder with some pain. I feel dehydrated when I wake up. This is most likely from some issues with my nasal cavity, causing my nose to swap to my mouth. I have not had blood in my urine. I am urinating semi-frequently. However, I would assume it is due to the gallon of water a day.

I have tried all kinds of things to stop it, like taking vitamins, changing my diet, exercise, drinking more water, and other drinks like Gatorade. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, you have been suffering from foul-smelling urination for months, feeling of pain during micturition, constant pain in the ribs, back pain, etc.

Foul-smelling urine with a feeling of some pain mostly indicates urinary tract infections (UTI). But you have already done some investigations which exclude UTI. Other than UTI, dehydration, and diabetes may be the possible causes. Dehydration is excluded as you usually drink lots of water. So, such type of clinical features may result from diabetes as the body is trying to get rid of excess blood sugar and is disposing of glucose through your urine.

Your rib and back pain may result from muscle strains or sprains, acid reflux, and many other causes.

You can undergo some investigations like RBS (random blood sugar) to exclude DM, USG (ultrasound) of W/A to exclude urethritis or prostatitis, serum creatinine to exclude any kidney problems, X-ray spine with KUB (kidney, ureter, and bladder) to exclude kidney stones, ECG (electrocardiography) and CXR (chest x-ray) to exclude chest and heart related any problems.

Your drug history, bowel movement history, and family history of arthritis are also important here for confirming any diagnosis.

I get a foul smell in my urine and pain during urination. Why?

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