Very frequently a mom will come here describing some painful experience her son is having when he urinates. 97% of the time this is just normal separation. Especially if there are no other symptoms of UTI present such as frequent urination, fever, etc.
The experience of pain or sting during urination will be more intense when the foreskin separates suddenly, as was the case for my son. Usually there will be some type of swelling and/or ballooning that occurs as well. The foreskin might separate all at once on one side and then slowly detach as the pressure from the urine knocks the connections loose. This means that the pain can go on for a few days. For my son the entire foreskin took about a day to knock loose, then the glans took about 3-4 days to smooth over and for him to not experience pain when urinating.
It is unclear why some boys experience this separation symptom more suddenly than others. For my son I believe that the cause was some early manipulation of his foreskin by a doctor. This is just another reason that doctors should not manipulate the foreskin for any reason. For other boys it could be that they are a little hard on themselves during self-exploration which starts the ball rolling sooner.
One of the remedies we have for this is to have the child pee in a cup of water however this does not often work for young boys. If the foreskin opening is still very narrow, the water will not be able to mix with the urine and dilute it so that it does not sting. For these boys, they will just have to weather the experience.
Also, the foreskin might not separate all at once and this symptom may come and go until complete separation has occurred.
The sting may be worse during times of the day when the urine is more concentrated. For my son it was bad all day. I've never heard him scream and cry the same way. It can be very painful. Sometimes a boy will be reluctant to pee to try to avoid the pain.
So point is that painful urination, even when it sounds very painful is likely to be normal separation. Especially if there are no other symptoms of UTI. Swelling is a good indication that it is separation but may or may not be present. Other symptoms that can be present are smegma discharge, ballooning and a small amount of blood.
Hope this helps other moms. I know I was super freaked out when this happened to my son b/c he was in excruciating pain. Just try to comfort your babe and wait and watch. As I said before it took my son about 5 days to be out of pain so it can be a rough few days. Unless you see other symptoms that could indicate UTI I wouldn't run to the doctor. They really are not familiar with the development of the intact boy and often do more harm than good.
Two good threads: