Kidney stone, UTI, or something more sinister?
Dear Dr Mitchell,What other cause could there be for smelly urine, other than a urinary tract infection (UTI)? I was treated with antibiotics for a UTI, but still have smelly pee (the distinct smell that comes with a UTI), with no other symptoms. Could it be a kidney stone or something more sinister?
The fact that you have an odour when passing your urine suggests that you definitely have an infection. The problem should have resolved if the antibiotics worked. It is important for you to have a repeat examination and get a urine culture done even if you did one before. It is likely that you could have a resistant strain of bacteria that is resulting in the recurrent urinary tract infection. It is also likely that this is a new bacteria that needs to be dealt with.
If you have a recurrent urinary tract infection it is important to get an ultrasound of the kidneys, urethra and bladder done. This will provide useful information such as any abnormal growth in the kidneys, urethra and bladder and also the presence of any stones that can result in the recurrent urinary tract infections.
In the presence of recurrent urinary tract infections, you should be screened for diabetes mellitus. This can be associated with the presence of recurrent infections. A fasting blood glucose or a random blood glucose irrespective of the time of the last meal can detect abnormal blood sugar levels.
Recurrent bladder or kidney infections can be triggered by exposure to infection during sexual activity, and so you need to have a complete physical examination with screening for sexually transmitted infections. Your partner should also be screened and treated to reduce the risk of recurrence.
A vaginal infection or other conditions such as cervical cancer can present with an odour from the urine or vagina. It is important to get a Pap smear done to screen for cervical cancer. This can present with an abnormal odour coming from the vagina on passing urine. In some women a foreign body such as a forgotten tampon, pieces of condom, or other forgotten foreign bodies can cause odour from the vagina on passing urine. A pelvic examination with the use of a vaginal speculum can determine if there is any foreign body left in the vagina.
It is vital for you to increase your daily fluid intake as this will help to flush the bladder out and help in reducing your risk of a urinary tract infection. If there is a stone in the urethra, kidney or bladder, then increasing your fluid intake and frequently emptying the bladder can have a significant flushing effect that helps to resolve the problem.
Consult your doctor who will advise you further and do the necessary investigations to determine if you have any underlying risk factors for this recurrent infection.
Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
