Strong and Unusual Odor in Urine for Two Weeks – Seeking Insights
Hello everyone, (I’m a 15-year-old female) For the past couple of weeks, I've noticed a remarkably strong and unpleasant odor every time I use the restroom. (Sorry, TMI) It has a scent reminiscent of a used tampon. This began shortly after my last menstrual cycle, though I can't pinpoint the precise day it started. I’ve conducted quite a bit of research and eliminated several possibilities: - I’m well-hydrated, consuming plenty of water each day, and my urine is often quite clear, yet the smell remains. - My dietary habits haven’t experienced any significant shifts over the last few months; I haven’t introduced foods typically linked with potent urine odors (like asparagus or coffee). - I am not sexually active (I’m still a virgin), so I don’t believe it pertains to any sexually transmitted infections. - In May, I underwent a comprehensive set of tests (including checks for bacterial vaginosis, yeast infections, UTIs, etc.), and the results came back negative. Of course, new issues could have arisen since then. Here are a few additional details that might be pertinent: - My vaginal discharge appears completely normal, without any unusual smells or colors. - I've been using the Nexplanon birth control implant since March. - I take Vyvanse; I took a break from it between May and August, and resumed on the 18th of August. - During my last menstrual period, I had severe cramps (among the worst I’ve ever experienced), which occurred just before this odor emerged. - I am not experiencing any pain, burning sensations, or additional symptoms—just the odor itself. - I’ve searched to see if there's any link between Nexplanon or Vyvanse and this issue, but didn’t find clear associations. Has anyone else had a similar experience? Or does anyone have any insights into what might be happening? I find myself quite confused and increasingly anxious about this. I’m considering scheduling a visit to the doctor to discuss my concerns soon. Thank you!
Answers (1)
9/3/2025, 11:01:40 PM
OpenHealth AI
It's understandable to feel anxious about the strong and unusual odor in your urine, especially since it's been noticeable for two weeks. While there are many possible explanations, it's important to approach this situation calmly and methodically. Here’s a breakdown of what might be happening and some steps you can take.
Explanation
Strong-smelling urine can result from various factors, many of which are usually benign. Some common causes include:
- Dehydration: Although you mentioned being well-hydrated, it's essential to ensure your fluid intake remains consistent.
- Diet: You noted no significant dietary changes, but even slight adjustments (like vitamins) can alter urine odor.
- Hormonal Changes: Fluctuations in hormones around your menstrual cycle or due to birth control methods like Nexplanon might influence changes in urine and body odor.
- Infections: It's good that you had tests for infections that returned negative, but new infections can develop, so keeping an open mind is wise.
It’s important to listen to your body and track any changes or new symptoms that may develop.
Next Steps
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Monitor Symptoms: Keep a daily log of when you notice the odor, your fluid intake, and any changes in your diet or lifestyle. Take note of your menstrual cycle and any related symptoms (like cramps).
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Hydration Check: Continue drinking plenty of water daily, aiming for about 8 cups (2 liters), unless otherwise advised. This helps dilute your urine.
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Diet Evaluation: Consider if you’ve recently started any new vitamins, supplements, or medications (like Vyvanse) that could contribute to changes.
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Consider Timing: Note if the odor correlates with specific times in your cycle or certain medications. This could provide insights.
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Consult Your Healthcare Provider: If the odor persists or worsens, or if you notice any new symptoms (like changes in discharge or pain), schedule a visit with your healthcare provider. Given your age and experience with Nexplanon and Vyvanse, they can help evaluate any potential hormonal or medication-related changes.
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Stay Positive: It’s perfectly normal to feel concerned, but many potential causes are easily manageable. Tracking your symptoms will empower you with information when discussing them with your healthcare provider.
It's great that you're considering a doctor visit; seeking professional guidance is the best way to ensure your well-being. Don't hesitate to reach out if you have more questions or need further clarification!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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**Portocaval shunt: 9.9 mm** (no change, continues to drain directly into the inferior vena cava avoiding liver acinus) - **Arteriovenous shunt: 4.4 mm** (no alteration) - **Three nodular cystic lesions** in perivascular space, maximum size 11.6×20.7 mm, enhancing in the venous phase - **Portal vein: 6.1 mm** (noted during porto-venous phase) - Arteries show no filling abnormalities - Intrahepatic bile ducts remain non-dilated - Gallbladder is elongated and slightly bigger, free from stones - Pancreas: normal - Spleen: measures 66.9×38.5 mm (not enlarged), splenic vein is 3.6 mm - Kidneys: normal placements and structure - No excess fluid detected in the abdominal cavity - No visible changes in lymph nodes **MSCT ANALYSIS:** "Congenital portosystemic shunt indicative of Abernethy malformation, unlikely to be AVM, presence of focal liver lesions cannot be ruled out." **RECOMMENDATION:** Engage with an abdominal and vascular surgeon. --- ## RECENT BLOOD WORK (December 2025 - January 2026) ### Complete Blood Count (January 19, 2026): - WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. 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