Differential Diagnosis for a 6-year-old girl hurting when she urinates, not UTI
- Single most likely diagnosis
- Vulvovaginitis: This is a common condition in young girls, often caused by poor hygiene, irritation from soaps or bubble baths, or viral infections. The symptoms include pain while urinating, itching, and redness of the vulva.
- Other Likely diagnoses
- Constipation: Constipation can cause pain in the pelvic area, which might be referred to the urethra, especially during urination.
- Urethral stricture or urethral irritation: Though less common, irritation or a stricture of the urethra could cause painful urination.
- Labial adhesions: This condition, where the labia minora stick together, can cause discomfort and pain, especially during urination.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sexual abuse: It's crucial to consider the possibility of sexual abuse in any child presenting with genital or urinary symptoms. A thorough and sensitive evaluation is necessary.
- Tumor or malignancy: Though rare, tumors such as rhabdomyosarcoma can present with urinary symptoms, including pain.
- Stones in the urinary tract: Kidney stones or bladder stones can cause severe pain, including during urination.
- Rare diagnoses
- Interstitial cystitis: A condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. It's rare in children but should be considered if other diagnoses are ruled out.
- Eosinophilic cystitis: An inflammatory condition of the bladder that can cause painful urination, among other symptoms. It's rare and often associated with allergies or eosinophilic disorders.
- Urethral prolapse: A condition where the mucosal lining of the urethra protrudes from the urethral opening, which can cause discomfort and pain during urination.