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Thursday, December 5, 2013
Urinary and Genital Disorders (Children)
3-year old Has Trouble Urinating
My 3-year old daughter stopped urinating. She is asking to go but after sitting on the toilet she would say it doesn`t work. The trip to ER showed no UTI. She had the reflux when she was a baby, but she outgrew it. Her urologist said it was emotional. She`s been potty trained for year and a half occasionally wetting at night, no accidents during a day. We didn`t have any changes in a family, no divorce, no move, she stays with me all day every day. No other changes in behavior. She would go once in 24 hours when she is already so full that she cries. It`s been almost a week. What is it?
This problem is not unusual, but can be troubling for girls and their parents. Often it is a sign of bladder/bowel dysfunction. Constipation can play a role. Typically, parents think that their child's bowel habits are normal. However, If they have a bowel movement less than once a day, if the stool is large (nearly blocking the toilet), or if the child takes more than 5 minutes to have a BM, then the child may be constipated. We have a fairly liberal definition for constipation if a child has urinary issues (UTI, reflux, incontinence, frequency, etc.). Typically we treat with Miralax (polyethylene glycol) powder. Some girls also experience bladder contraction after voiding, and they may respond to an anticholinergic medication such as oxybutynin.
This condition often is difficult to treat, but it generally resolves on its own over a period of 1 to 2 months.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University