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Urinary and Genital Disorders (Children)

My 10 yr old Daughter Reeks of Urine Smell

02/16/2010

Question:

My 10 yr old has a strong urine smell and has daily urine accidents. it has been going on for years. When I pick her up from school smell gets so bad in the car that I can hardly breath. She has been checked for urinary track and it was negative. She is not consitipated. Some days she has 2-3 accidents, where when she gets up there`s a wet spot, or when she changes her underwear she is wet with extremely strong urine smell. She has no friends and sees a counselor which has not been able to help her. I am worried about her and what this could do to her in school and socially. She does not seem to care. She seems to hold it until it comes out. I am not sure how to stop it and/or what could be the causes. Please help me.

Answer:

It is unusual for a 10-year-old girl to have such a strong urinary odor and incontinence. There are many potential causes. It sounds like she needs a pediatric urological evaluation. Generally we obtain a complete medical history, with information relating to previous UTIs and details regarding the incontinence. In addition, a thorough physical examination (non-invasive) is performed. In addition, a urinalysis is obtained and a bladder scan is performed to check to be certain that the bladder empties completely. Subsequently, often a renal and bladder sonogram is performed to check on her anatomy.

Usually, with this information, a diagnosis and treatment plan can be recommended. The most common diagnosis is "dysfunctional elimination syndrome", also known as bladder-bowel dysfunction. In some cases further testing is required.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University