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Thursday, May 23, 2013
Urinary and Genital Disorders (Children)
Almost 4, refusing to urinate until it hurts
Urologist say nothing is wrong. VCG test negative, bladder fine, kidneys and ureters are fine, but child is having difficulty urinating. No problems with bowel movements. Help.
There is not much information to determine why she is not voiding. However, it sounds like she has dysfunctional elimination syndrome. Often there is underlying constipation, and treatment with a mild laxative often helps considerably. Alternatively, some girls simply have difficulty relaxing their pelvic floor muscles, to allow the urine to come out.
It sounds like she should see a pediatric urologist or "urotherapist" who has a special interest in disorders of voiding.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University