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ABCs of dysuria w/o UTI

A young girl comes in c/o dysuria and the urine is stone cold normal. What else can explain her symptoms? (BTW, you must do a GU exam at this point).

Adhesions (labial)

Bubble bath (and other soaps, irritants)

Candida (particularly if recently on antibiotics, or at risk for new onset diabetes)

Detergent (harsh laundry detergent, new tight clothing / underwear)

Enterobius (aka pinworms)

Foreign body (typically toilet paper)

Gonorrhea & chlamydia (in sexually active or sexually abused)

Hygiene, poor (teach girls to wipe front to back, consider having them sit on toilet backwards to urinate, especially if they are overweight/obese, to encourage complete voiding and keep urine from collecting in vagina)

Irritation (masturbation is a common normal behavior in preschoolers)


pemsou5_wp • March 21, 2017

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