‘Bubbly’ Pee

“We are raising today’s children in sterile, risk-averse and highly structured environments. In so doing, we are failing to cultivate artists, pioneers and entrepreneurs. Instead, we cultivate a generation of children who can follow the rules in organized sports games, sit for hours in front of screens and mark bubbles on standardized tests”, claimed Darrell Hammond, the comedian who set the record for the longest consecutive tenure of any Saturday Night Life cast member in the show’s history.

I often asked myself: “Is it true that we are so protective in the upbringing of children, to the extent that they all grow up in a bubble wrap and never learn to challenge?”

I was convinced that kids have a shielding nurturing environment until I came across a TED talk featuring American child prodigy Adora Lily Svitak. This child sensation is an author who had published international acclaimed essays, poems, blogs, books and is into advocacy work.

She became known to the public at the age of 6 and was commenting on matters of international significance and promoting literacy and writing. In her 2010 TED conference, Svitak said the world need “childish” thinking, bold ideas, wild creativity and optimism.

This genius is a believer that adult can learn from the kids. Svitak once said: “Enthusiasm just creates bubbles; it doesn’t keep them popping.” On that note, we are dealing with bubbly pee that is bothering a kid, who cares about his/her father.

Dear Dr G,

Thank you for reading my email. I know you normally deal with sexual matters. However, I think you are a urologist and therefore I think you are able to help me.

I am 15, and I am worried about my dad who is 46-years-old. My dad works in a bank and he has a bad habit of smoking.

Apart from smoking, my dad also has this bad habit of not flushing the toilet after urining. I have been noticing a lot of bubbles in the toilet bowl after he pees, and this has been going on for quite a while.

I read an article somewhere that foamy urine is related to kidney damage, is that true? I have been telling him to get this checked out. He insisted it is the detergent in the toilet bowl that is causing the froth.

I am worried about my dad and wandering how to get him checked out?

Thanks for helping,

Jo

First and foremost, thank you for acknowledging the work of a urologist is not completely sexual in nature. In fact, for most urologists, sexual health matters only constitute a small part of the workload, and the rest would include stone disease, male cancers, incontinence and infections.

Passing frothy urine occasionally is quite a normal phenomenon. In fact, the frothiness can be influenced by the speed of the urine or the cleaning agent in the bowl. The persistently foamy urine noticed over a longer interval can be more serious and may be due to protein in the urine.

This is a condition called proteinuria. As the leakages of protein in the urine can be a sign of kidney damage, such symptom may require further evaluation.

The foaminess of urine can be due to many other impurities in the excrement, apart from protein. These include bilirubin (the component that results in jaundice) or true bubbles that is mixed with urine (pneumaturia) as a result of abnormal communications of bladder with rectum (fistula).

Occasionally, frothy urine can also be caused by semen that is mixed with urine after ejaculation. Yes, you read correctly, the semen can have back flow into the bladder for men who suffer from dry orgasm or retrograde ejaculation. This is commonly associated with medications such as alpha-blockers.

The presence of protein in the urine may not be totally pathological. Stress, dehydration, strenuous exercise or even posture (benign orthostatic proteinuria) can induce the leakages of protein into the urine.

Other benign or less serious causes of proteinuria can include urinary tract infection, diabetes, high blood pressure or excessive usage of painkillers such as non-steroidal anti-inflammatory analgesia.

Detailed investigations in order to rule out serious kidney injuries such as nephrotic syndrome, glomerular nephritis and glomerulosclerosis are usually warranted to prevent permanent irreversible damage to the kidneys.

Conventionally, a simple “dipstix” tests followed by 24 hours collection of urine can determine the extent of the proteinuria. Kidney biopsy may also be necessary if excessive protein loss is indicated.

I am deeply moved by this email I received from a reader, who is concerned about his/her father’s state of health. I guess after all, we should give more credit to children who are ready to challenge the norm.

Since the father is a man who works in the world of finance, Dr G’s suggestion is for Jo to ponder over this quote by famous money-man George Soros: “Stock market bubbles don’t grow out of thin air. They have solid basis in reality, but reality as distorted by a misconception”. Get the urine dipped and this is the only way to get the “bubbles of doubts” vanished into thin air!