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Urinary and Genital Disorders (Children)

UTI Symptoms with No Infections

11/19/2010

Question:

My five year old is displaying symptoms of a UTI, she is going to toilet every five to ten minutes feeling as if she needs to urinate but can’t. She also complains that urination burns and that her lower stomach (bladder area) hurts. We have taken her to the doctor 2 times and both times she has tested negative for any infection ruling out a UTI or kidney infection, which she has had problems with in the past, but there have been no problems since a kidney reflux surgery. We are scheduled to see a urologist in a few weeks in the mean time what could cause these problems.

Answer:

Frequent urination with burning is often due to urinary tract infections (UTI) but can also be due to other things such as vulvovaginitis. The first step as you've done would be to check a urine culture to rule out a UTI. Vulvovaginitis is typically not a bacterial infection but is due to inflammation of the area around her vagina, sometimes from leaving a little toilet paper behind after wiping. It is very common at this age. You would see intense redness around the vagina area and it can cause the exact same symptoms as a bladder infection. This can be treated with soaking her in Aveeno oatmeal baths for 20 minutes and then rinsing her off with clear water. It's important to dry her bottom very well and if she doesn't have bedwetting problems, you can put her in a pajama dress without underwear overnight to let it air out.

Other causes of urinary frequency include constipation (from impacted stool pushing on the bladder and causing a bladder spasm) as well as dietary irritants. These include caffeine, carbonation, chocolate (which has caffeine in it), and citrus drinks. It's important to discuss these symptoms with your doctor as well as your urologist and let them know if you have any other symptoms such as incontinence or blood in the urine.

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Response by:

William Robert DeFoor, MD, MPH William Robert DeFoor, MD, MPH
Associate Professor of Surgery
College of Medicine
University of Cincinnati