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The following conditions can sometimes cause smelly urine, but they are uncommon: 1  urinary stones â these may cause an ammonia-like odour (read about bladder stones and kidney stones) 2  a bladder fistula â this is an abnormal connection between your intestines and bladder.
Causes. Urine odor is related to the volume and concentration of a variety of substances excreted by the kidneys. Normally, urine that contains a lot of water has little to no odor. If your urine becomes highly concentrated â a high level of waste products with little water â urine odor may have a strong ammonia smell. Many foods and medications, such as asparagus or certain vitamins, can affect the odor of urine. Sometimes, unusual urine odor may indicate a medical condition or disease, such as: 1  Bladder infection. 2  Cystitis (bladder inflammation). 3  Dehydration. 4  Diabetic ketoacidosis (high levels of blood acids called ketones). 5  Gastrointestinal-bladder fistula (abnormal connection between the intestines and bladder).