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Strong smelling urine, no burning, back pain, exhausted. Is it a urinary tract infection?

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Practicing since : 2002
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I am 33 years old overall healthy women. I have noticed in the past month in a half that my urine has had an odor. I have always had urgency and frequency since my hysterectomy 5 years ago. Thinking I could just be dehydrated I cut all caffine out and making sure I drank plenty of water and a Zero (like gaterade) drink everyday for 4 days. It did not help. My urine is medium yellow, very cloudy and very strong smelling for the past 10 days. No burning while I pee. Sometimes in the night I wake up with lower back pain. Don't notice the back pain so much during the day. It's more of a can't get comfortable pain. I feel exhausted all the time. I am a nurse and get a lot of UA samples and by far my urine has the strongest odor I have ever smelled. Do you think it could be more then just a urinary tract infection? What do you recommend?
Posted Fri, 27 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Robert Galamaga 1 hour later

Thank you for submitting your question.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding your concerns.

You have indicated in your question that you have noticed a change in color and order of your urine . While this is not accompanied by symptoms which would be considered obvious for a urinalysis and urine culture.

You may be dealing with a low level infection which is not severe enough to cause symptoms. The fact that you feel fatigued and tired maybe related but is possibly secondary to something else. Also it is possible to have a fungal infection in the urine as well which could cause symptoms like you are experiencing. In addition if the normal bacteria in the vagina are disturbed it can cause a change in the way the urine looks and smells. This is referred to as bacterial vaginosis. Sometimes this type of thing will be accompanied by a discharge from the vagina.

You also mentioned that even though you drink plenty of fluids you still noticed some discoloration in the urine. This is surprising. I would think that your urine would eventually turned clear if you're drinking a significant degree of fluids. You could try challenging your urinary tract with a significant degree of fluids over the next one or two days by drinking three or 4 L of fluid per day. Your kidneys should have no problem processing this fluid and your urine should turn clear.

Again I thank you for submitting your question. I think right now the clear solution involves a complete urinalysis and culture. If you have any additional concerns I would be happy to address them here. One additional thing you could try would be to start taking a daily acidophilus supplement. This would help restore good and normal bacteria which are normally present in the vagina.

Again I would be happy to address any additional concerns you might have.


Dr. Robert
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