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Urinary and Genital Disorders (Children)

Toddler Urinary Frequency

09/28/2010

Question:

My 4 y.o. daughter recently started wetting the bed for the past 3 nights. She has never wet the bed before even with potty training since she was 2. She has to pee constantly and complains about having to go but not being able to void. She says it itches but doesn`t scratch so maybe burning or hurting instead. Took her to ER and urinalysis negative. She drinks only water and diluted grape juice. Seems she isn`t voiding properly. What should I do now?

Answer:

There are several potential causes for this condition. The first is a urinary tract infection, but it is reassuring that her urinalysis was normal. With itching, we often consider pinworms as a cause. This condition is not rare in 4-year-old girls. Another cause is an elevated calcium level in the urine, although that is uncommon if she drinks only water and grape juice, and not milk. Another potential cause is constipation. Even though parents think that their child is normal, some children have symptoms of constipation, including abdominal pain; large bowel movements, which can block the toilet; a bowel movement less than once per day; passing small amounts of stool; painful bowel movements. Finally, in some cases, even if the urinalysis and urine culture are normal, if there is no other cause, we will prescribe an antibiotic to treat an undiagnosed lower urinary tract infection.

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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