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Urinary and Genital Disorders (Children)

Almost 4, refusing to urinate until it hurts

10/15/2008

Question:

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.

Answer:

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.

For more information:

Go to the Urinary and Genital Disorders (Children) health topic, where you can:

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