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Urinary and Genital Disorders (Children)

Toddler`s Pain

02/18/2009

Question:

My two year old daughter, for about the past three months has been complaining about pain in her vaginal area, mostly after her diaper has been changed, any type of pants except very loose fitting are put on her (ie denim), and when she is buckled up (the buckle comes between her legs). I have taken her to the doctor twice and no one has seen anything unusual. They did a culture and her urine was normal. My pediatrician said that I should just ignore it, but I`m very certain that she`s not making this up. Does anyone know of something else this could be? It breaks my heart when she cries and says "mommy it HURTS!" and I don`t know what to do.

Thank you for your time.

Answer:

This is a difficult problem. One of the most common causes of a cramping pain in the vaginal area is constipation, which can cause "referred" pain to the genital area. This condition is treatable with a gentle laxative such as Miralax. Another cause is external irritation from a product in the diaper, although that would usually cause external irritation. It also can result from pinworms, although that is rare. If there is significant discomfort, it is a good idea to obtain a bladder ultrasound to be certain that there is no other structural cause.

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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