Urethritis (Caused by Soap) in Young Boys

What is urethritis?

Urethritis is when the urethra becomes irritated or infected. The urethra is the tube that connects the bladder to the end of the penis. It carries the urine out of the bladder. The main symptom is burning or discomfort when passing urine. If the boy is not circumcised, the foreskin may also be irritated and itchy. This problem only occurs in young boys, long before puberty.

What is the cause?

Most urethritis in young boys is due to a soap irritation of the urethra opening. The usual irritants are bubble bath, shampoo, or soap left under the foreskin. Before puberty, the lining of the opening of the penis is thin and sensitive to soaps. If the urethritis spreads to the bladder, a bladder infection can occur (cystitis). This will cause worse symptoms such as more pain with passing urine, frequent urination and wetting. In addition, the urine will become cloudy and have a bad odor. If the foreskin becomes infected, pus may occur.

How is it diagnosed?

Any child with painful urination needs a urine sample checked in a lab. This is to rule out a bladder infection. Soap urethritis is diagnosed by having symptoms of pain or mild discomfort when passing urine plus a normal urine exam.

How can I take care of my child?

• Pain relief

  Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for the painful urination.

• Cleanse with warm water

  Cleanse the end of the penis with warm water. If your boy is not circumcised, pull back the foreskin as far as it will easily go and also rinse that area. Never use soap under the foreskin or on the end of the penis. Have your son soak his bottom in a basin or bathtub of warm water for 10 minutes. Repeat this twice a day for the next 2 days. This will remove any irritants from the genital area and promote healing. After the symptoms go away, cleanse the genital area once a day with warm water.

• Hydrocortisone cream

  Apply a tiny amount of 1% hydrocortisone cream (a nonprescription item) to the end of the penis. Dry the area first. Do this for 2 days, then stop using it.

• Drink enough fluids

  Encourage him to drink enough fluids to keep the urine light-colored. Concentrated urine can be an irritant.

How long does it last?

The discomfort goes away after 1 to 2 days of proper treatment.

How can I prevent recurrences?

• Only cleanse the penis with warm water (soap is not needed before puberty).
• Don't use bubble bath before puberty because it can be very irritating to the opening of the penis. Try not to put any other soaps or shampoo into the bath water. Don't let a bar of soap float around in the bathtub. If you are going to shampoo your child's hair, do this at the end of the bath or only during showers.
• Keep the bath time less than 10 minutes. Have your child try to urinate immediately after baths.

When should I call my child's healthcare provider?

Call during office hours if:

• A urine sample hasn’t been checked for infection
• The pain and itching is not gone after 48 hours of treatment.
• Passing urine becomes more painful.
• You have other concerns or questions.