Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version
Illustration

DESCRIPTION

• Your daughter feels discomfort when she urinates.
• She feels a burning or stinging when she urinates.
• She has an urgent and frequent need to urinate (in some cases).
• She uses bubble bath, bathes in soapy bath water, or washes her genital area with soap.
• She is prepubertal.
• Your daughter has no sign of a urinary tract infection.

CAUSE

The most common cause of mild pain or burning with urination in young girls is an irritation of the vulva (vulvitis) and the opening of the urethra (urethritis). Before puberty, the lining of the vulva is very thin and sensitive. The irritation is usually caused by chemicals in bubble bath, shampoo, or soap that was left on the genital area. Occasionally it results from poor cleansing of the genital area after a bowel movement.

For more information see:

Vaginal Irritation and Itching (Chemical Vulvitis)

Irritation by chemicals is almost always the cause of urethritis or vulvitis that occurs before a child reaches puberty. However, 5% of young girls do get urinary tract infections (UTI), which can cause the same symptoms. A UTI is a bacterial infection of the bladder (cystitis) and sometimes the kidneys. UTIs must be treated by your physician.

For more information see:

Urinary Tract Infection

EXPECTED COURSE OF BUBBLE BATH (CHEMICAL) URETHRITIS

With warm soaks, the pain and burning usually clear in 12 hours.

HOME CARE

1. Warm baking soda/water soaks

   Have your daughter soak her bottom in a basin or bathtub of warm water for 20 minutes. Put 4 tablespoons of baking soda in the water. Be sure she spreads her legs and allows the water to cleanse the genital area. No soap should be used. Repeat this every 4 hours while she is awake. These soaks will remove any soap, concentrated urine, or other irritants from the genital area. It will also promote healing. With soaks, the burning will usually clear in 24 hours. Thereafter, cleanse the genital area once a day with warm water.

2. Instructions for collecting a midstream, clean-catch urine specimen at home

   If you are told to bring in a urine sample, try to collect the first one in the morning. Use a sterile jar.

   Wash off the genital area several times with cotton balls and warm water. Have your child then sit on the toilet seat with her legs spread widely so that the labia (skin folds of the vagina) don't touch. Have her start to urinate into the toilet, and then place the clean container directly in line with the urine stream. Remove it after you have collected a few ounces but before she stops urinating. The first or last ounce that comes out of the bladder may be contaminated.

   Keep the urine in the refrigerator until you take it to the office. Keep it cool when you bring it to the office by placing it in a cooler or a plastic bag with some ice.

PREVENTION OF RECURRENCES OF PAIN WITH URINATION

• Wash the genital area with water, not soap.
• Don't use bubble bath before puberty. Don't put any other soaps or shampoo into the bath water. Don't let a bar of soap float around in the bathtub. If you are going to shampoo your child's hair, do this at the end of the bath.
• Keep bath time less than 15 minutes. Have your child urinate immediately after baths.
• Teach your daughter to wipe herself correctly from front to back, especially after a bowel movement.
• Encourage her to drink enough fluids each day to keep the urine light colored.
• Encourage her to urinate at least every 4 hours during the day.
• Have her wear cotton underpants. Underpants made of synthetic fibers (polyester or nylon) don't allow the skin to "breathe." Discourage wearing underpants during the night.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

• The pain with urination becomes severe.
• Your child also has abdominal or back pain.
• Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The pain continues more than 24 hours after warm baking soda/water soaks.
• Your child develops a fever.
• You have other questions or concerns.