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What Causes Excessive Crying Before Urination?
Question: 2 month old boy screams horribly about 2 minutes before urination. He clenches his body very tightly and screams until his voice cracks. 2 minutes after urinating, he is fine again. Also, his belly button pops out (hernia?) many times during the day. Otherwise he is healthy and happy. Here is some more information:
- his urine stream is not thin and there is no swelling of his penis tip and the urine shoots about 1 to 2 feet (seems to be good pressure)
- his urine does not have a strong bad smell and is generally mostly clear and it is not cloudy and not bloody or dark or yellow
- he does not have a fever or cold or cough or diarrhea. He has bowel movements only about twice per day, but they look and smell normal
- he does not cry when touched anywhere and there is no pain or swelling anywhere on his body
- we do have a woman put oil on him and massage him every morning (no crying during this)
- he has normal hunger and is mostly breastfed - he does get the bottle once or twice per day (which contains water and milk powder)
- this has been going on for about 3 weeks, but has gotten really bad (more screaming) for only the past 1 week
- his urine stream is not thin and there is no swelling of his penis tip and the urine shoots about 1 to 2 feet (seems to be good pressure)
- his urine does not have a strong bad smell and is generally mostly clear and it is not cloudy and not bloody or dark or yellow
- he does not have a fever or cold or cough or diarrhea. He has bowel movements only about twice per day, but they look and smell normal
- he does not cry when touched anywhere and there is no pain or swelling anywhere on his body
- we do have a woman put oil on him and massage him every morning (no crying during this)
- he has normal hunger and is mostly breastfed - he does get the bottle once or twice per day (which contains water and milk powder)
- this has been going on for about 3 weeks, but has gotten really bad (more screaming) for only the past 1 week
Brief Answer:
Symptoms likely to be due to tight prepuce
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
Excessive crying in male baby with good urinary stream is quite common. Good Urinary stream is very much reassuring. Infants have to urinate by raising intra-abdominal pressure . They sometimes achieve it by crying. Also other possibility of excessive crying is Phimosis(tight prepucial skin covering the glans penis.
I would suggest you the following which will help with excessive crying while passing urine
1. Hot seitz bath: To a small tub add lukewarm water( immerse your hand in it and you should be able to tolerate the warm water for 30 seconds, then it is safe for baby). Add handful of common table salt in it. After the baby maasge, make the baby sit in it for 10 minutes, also clean the tip of penis with it.
2. Give a good warm baby bath to the baby
3. Betnovate Ointment: After the bath, wipe the baby dry. Slightly pull back the skin of tip of penis( no excess force), apply Betnovate ointment to the tip using little finger, replace back the skin. No forceful pulling back
The baby should be okay in couple of days.
Coming to issue of swelling in the belly(umbilicus). Its likley to be Umbilical hernia. It occurs due to small defect in abdominal wall. The swelling becomes more obvious when the baby cries. As the baby grows the defect reduces and the sweliing(hernia) subsides. Being a Pediatric Surgeon, i see the babies once in 6 months, in majority of cases it reduces by 6 months and in some cases till 2 years. No Surgery or any local treatment. There is definitely no cause for concern.
Do get back to me if you need any further assistance, will be glad to assist you.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
Symptoms likely to be due to tight prepuce
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
Excessive crying in male baby with good urinary stream is quite common. Good Urinary stream is very much reassuring. Infants have to urinate by raising intra-abdominal pressure . They sometimes achieve it by crying. Also other possibility of excessive crying is Phimosis(tight prepucial skin covering the glans penis.
I would suggest you the following which will help with excessive crying while passing urine
1. Hot seitz bath: To a small tub add lukewarm water( immerse your hand in it and you should be able to tolerate the warm water for 30 seconds, then it is safe for baby). Add handful of common table salt in it. After the baby maasge, make the baby sit in it for 10 minutes, also clean the tip of penis with it.
2. Give a good warm baby bath to the baby
3. Betnovate Ointment: After the bath, wipe the baby dry. Slightly pull back the skin of tip of penis( no excess force), apply Betnovate ointment to the tip using little finger, replace back the skin. No forceful pulling back
The baby should be okay in couple of days.
Coming to issue of swelling in the belly(umbilicus). Its likley to be Umbilical hernia. It occurs due to small defect in abdominal wall. The swelling becomes more obvious when the baby cries. As the baby grows the defect reduces and the sweliing(hernia) subsides. Being a Pediatric Surgeon, i see the babies once in 6 months, in majority of cases it reduces by 6 months and in some cases till 2 years. No Surgery or any local treatment. There is definitely no cause for concern.
Do get back to me if you need any further assistance, will be glad to assist you.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks for your prompt and thorough response. I sent a follow up question, but I don't see it listed online so I am asking it again... my follow up was regarding his bowl movements. I stated that he had 1 to 2 movements per day, but that is not correct. Actually, he has only 1 movement every two days. How is this related to his other problems, and how to fix this final issue?
Thanks again for your help.
Thanks for your prompt and thorough response. I sent a follow up question, but I don't see it listed online so I am asking it again... my follow up was regarding his bowl movements. I stated that he had 1 to 2 movements per day, but that is not correct. Actually, he has only 1 movement every two days. How is this related to his other problems, and how to fix this final issue?
Thanks again for your help.
Brief Answer:
It could be normal varaition
Detailed Answer:
Namasthe
Good morning
Every child is unique and have their own bowel habits and frequency.
Few babies pass stools 2-6 time a say, few baby pass stools once in 2 - 3 days
There is no cause for concern if the following criteria are fulfilled
1. No straining while passing stools
2. Stools are soft or semi solid in consistency
3. No distension of abdomen
4. Accepting feeds well
5. Gaining weight adequately
6. Baby is playful and jolly.
How is the baby doing? has the excessive crying while passing Urine settled down?
Do get back to me
Regards
Dr Deepak
It could be normal varaition
Detailed Answer:
Namasthe
Good morning
Every child is unique and have their own bowel habits and frequency.
Few babies pass stools 2-6 time a say, few baby pass stools once in 2 - 3 days
There is no cause for concern if the following criteria are fulfilled
1. No straining while passing stools
2. Stools are soft or semi solid in consistency
3. No distension of abdomen
4. Accepting feeds well
5. Gaining weight adequately
6. Baby is playful and jolly.
How is the baby doing? has the excessive crying while passing Urine settled down?
Do get back to me
Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks for your usual quick and full response. We have been doing the salt and Betnovet treatment for about 3 days now (twice per day), and he seemed to be doing the desperate crying only 2 times per day, which was an improvement... But unfortunately, today he screamed badly 7 times out of 10 during and before passing urine. Quality of urine and other symptoms are the Dame as in my original message. I am starting to worry again. What can I do to stop his suffering?
Thanks for your usual quick and full response. We have been doing the salt and Betnovet treatment for about 3 days now (twice per day), and he seemed to be doing the desperate crying only 2 times per day, which was an improvement... But unfortunately, today he screamed badly 7 times out of 10 during and before passing urine. Quality of urine and other symptoms are the Dame as in my original message. I am starting to worry again. What can I do to stop his suffering?
Brief Answer:
Additonal inf required
Detailed Answer:
Namasthe
Greetings
I would like to know additional information
1. Can the skin over the glans that is prepuce be pulled smoothly back?
2. Does he stop crying after passing urine?
3. Is there any ballooning of prepuce while passing urine?
In the meantime continue giving seitz salt bath and betnovate
Take Care
Regards
Deepak
Additonal inf required
Detailed Answer:
Namasthe
Greetings
I would like to know additional information
1. Can the skin over the glans that is prepuce be pulled smoothly back?
2. Does he stop crying after passing urine?
3. Is there any ballooning of prepuce while passing urine?
In the meantime continue giving seitz salt bath and betnovate
Take Care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi -
Thanks for your response. To anwer your questions:
1) Yes, the skin can be pulled smoothly back (of course, we are only pulling it back very slightly like you prescribed in your original response).
2) He does stop crying after passing urine, but it takes 1 or 2 minutes (not more). He screams a little, but eventually calms down - that whole process takes about 2 minutes.
3) We are not aware of any obvious ballooning during passing of urine, but we have not been observing that - we will do this and report back to you.
Thanks again for everything.
Thanks for your response. To anwer your questions:
1) Yes, the skin can be pulled smoothly back (of course, we are only pulling it back very slightly like you prescribed in your original response).
2) He does stop crying after passing urine, but it takes 1 or 2 minutes (not more). He screams a little, but eventually calms down - that whole process takes about 2 minutes.
3) We are not aware of any obvious ballooning during passing of urine, but we have not been observing that - we will do this and report back to you.
Thanks again for everything.
Brief Answer:
Further routine investigation required
Detailed Answer:
Hi
A baby having good urine stream is very much reassuring as it rules out many obstructive lesion of urinary tract. Adults pass urine by increasing the intra-abdominal pressure by staining. Babies cannot do that , they increase intra-abdominal pressure by crying which leads to evacuation of urinary bladder.
Its unlikely that there could be any significant problem with the baby.
I would advise you the following
1. Urine Routine and microscopic examination
2. Ultrasound of Urinary system
It will be very much reassuring and will rule out remote possibility of having missed out something. In my clinical practise, a baby presenting with excessive crying while passing urine , i get these investigations done which are noninvasive.
Do get back to me with the progress and workup.
Take Care
Best Regards
Dr Deepak
Further routine investigation required
Detailed Answer:
Hi
A baby having good urine stream is very much reassuring as it rules out many obstructive lesion of urinary tract. Adults pass urine by increasing the intra-abdominal pressure by staining. Babies cannot do that , they increase intra-abdominal pressure by crying which leads to evacuation of urinary bladder.
Its unlikely that there could be any significant problem with the baby.
I would advise you the following
1. Urine Routine and microscopic examination
2. Ultrasound of Urinary system
It will be very much reassuring and will rule out remote possibility of having missed out something. In my clinical practise, a baby presenting with excessive crying while passing urine , i get these investigations done which are noninvasive.
Do get back to me with the progress and workup.
Take Care
Best Regards
Dr Deepak
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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