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Tuesday, May 21, 2013
Urinary and Genital Disorders (Children)
My daughter is 12 years old. She has not yet started menstrating. For the past few years, she has gradually been having difficulties with urination. She is able to go, but will sit on the toilet for a long time feeling like she is not done. Or she will get up, only to return a minute later because she "hasn`t wiped well enough". 3 weeks ago, she got a sore just inside the vagina. It was so bad that she cried at the thought of peeing. Test were done, and everything was negative. It has since cleared up. Since then, she now has cramps whenever she feels the need to urinate. She had an ultrasound which did confirm she is retaining about 100ml of urine. I am waiting to see a urologist but am very concerned. I keep reading that this is NOT a common thing. Could you give me an idea of what test may be performed at her appointment, what may have to be done and what could be the cause in the first place. Thak you
Your daughter's urinary retention is an unusual condition, but it is unclear what the cause is. I am uncertain what tests have been done thus far. Generally in cases like this a sonogram of the urinary tract is performed, checking for the amount of urine retained in the bladder after urinating. In addition, often a thorough evaluation for associated conditions including constipation and neurological disorders is performed. Often a procedure called urodynamics is performed, in which the bladder is filled with water, and the pressure in the bladder is measured.
Also, the ability to urinate and the process of urination is analyzed. Often this procedure is combined with an x-ray study of the bladder to watch the bladder fill and empty. Sometimes we perform a uroflow study in which the patient sits on a toilet and urinates into a receptacle that has a monitor for the rate of urine flow. If these tests do not solve the problem, then occasionally more extensive testing such as an MRI or cystoscopy are performed.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University