Differential Diagnosis for a 2-year-old with Urinary Hesitancy
Single most likely diagnosis
- Functional urinary retention due to potty training: This is the most likely diagnosis given the recent start of potty training. Children may experience anxiety or reluctance to urinate in the toilet, leading to urinary hesitancy.
Other Likely diagnoses
- Urinary tract infection (UTI): UTIs are common in young children and can cause urinary hesitancy, frequency, and discomfort.
- Constipation: Constipation can cause urinary hesitancy and retention due to the proximity of the rectum to the urethra and bladder.
- Dysfunctional voiding: This condition is characterized by an inability to relax the pelvic floor muscles during urination, leading to urinary hesitancy and retention.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Posterior urethral valves: A congenital condition that can cause urinary obstruction and retention, leading to renal damage if left untreated.
- Neurogenic bladder: A condition caused by a neurological disorder (e.g., spina bifida) that affects bladder function, leading to urinary retention and incontinence.
- Tumor or mass compressing the urethra: A rare but potentially life-threatening condition that requires prompt diagnosis and treatment.
Rare diagnoses
- Urethral stricture or stenosis: A narrowing of the urethra that can cause urinary hesitancy and retention.
- Bladder neck obstruction: A rare condition that can cause urinary retention and hesitancy.
- Spinal cord injury or tumor: A rare but potentially serious condition that can affect bladder function and cause urinary retention and incontinence.