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Urinary and Genital Disorders (Children)

Occasional pain after urination for 7 yr old

12/10/2007

Question:

My 7 year old daughter has been to the pediatrician 7 times since January 2007 and once to an urologist due to occasional pain after urination. All of her urine cultures have been negative. The pain will last for 1-2 days then disappear. The onset does not have a frequency or pattern. She drinks water daily, low sugar intake, but has frequent constipation. In July she had gastro-intestinal surgery and frequently takes a laxative to keep her bowel movements regular. The doctor is hesitant to prescribe medication due to negative urine cultures. I have tried baking soda in bath water; no soap only baby wash, no tight fitting clothing, and using over the counter creams for when her vaginal area is red. The problem is not going away and I take her to her pediatrician when the UTI symptoms occur. Is there any other possible course of action? It is hard to watch your child suffer with no relief for 24-48 hours.

Answer:

There are several possible causes, but none are common.

Occasionally the discomfort results from incomplete wiping after urination. Another cause is a bladder spasm at the end of voiding, in which the bladder tightens, similar to a muscular cramp. Another possibility is underlying constipation, which can result in a similar feeling of a muscular spasm. Occasionally mild urethritis (bacterial) may occur, causing pain during urination without a positive urine culture. In addition, getting soap around the urethral opening can cause a significant burning sensation.

One treatment option is to take a low dose of Pyridium (phenazopyridine), which can be obtained over the counter in low doses. It is also beneficial to drink plenty of water and avoid soda and excessive juice. Finally, be certain that bowel movements are regular.

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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