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Urinary and Genital Disorders (Children)

Leaking in 6 Year Old After Voiding

08/03/2011

Question:

My 6 year old leaks urine after voiding. This has been the case ever since she was toilet trained. She is very uncomfortable with this! How can this problem be solved?

Answer:

There are two common causes of this problem, which is generally termed vaginal voiding. The most common cause is that the child sits with their legs together, compressing the labia together and some of the urine goes backwards into the vagina. When they stand up, the urine dribbles out. To prevent this problem, the legs should be widely separated over the toilet. One common technique to teach girls how to sit is to have them sit backwards on the toilet seat, which forces the legs to separate. The second cause is a labial adhesion, in which there is fusion of the labia minora. This condition is diagnosed by examining the labia while the child is lying on her back in a frog-leg position. When the labia are separated, the urethral and vaginal openings should be easily visible; if they are not visible, then a labial adhesion may be present. This condition often is treatable with topical estrogen or corticosteroid cream, and occasionally by separation in the office or operating room.

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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