What should you know about fishy cloudy urine?

A strong fish-like smell can occur when urine is concentrated, especially if you have not been drinking enough. Cloudiness may also come from crystals, mucus, cells, or pus. A urinary tract infection can cause an unusual smell and cloudy urine, often alongside burning, urgency, or passing urine frequently. If infection affects the kidneys, fever, chills, nausea, or pain in the side or back may appear. Smell alone does not identify the cause.

Drink fluids regularly unless a clinician has told you to restrict them, and observe whether the change settles. Note its onset, colour, smell, pain, urinary frequency, fever, vaginal discharge, or recent foods and medicines. Arrange a clinical review if it persists, recurs, or comes with urinary symptoms; testing may include a urine sample.

Seek prompt medical advice for fever, shivering, pain in the back or side, vomiting, blood in the urine, or feeling significantly unwell. Urgent help is appropriate if you cannot pass urine, become confused, or develop severe pain. These features can need treatment without delay.

Could this be a urinary tract infection or dehydration? Do I need a urine test? Which symptoms should prompt same-day care? Could a medicine, supplement, or genital discharge be affecting the smell?