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Wet Knickers
Question:
I have a five year old daughter, she started school in February.She is fully toilet trained and sleeps through the night with no wetting.Just lately she has told me of having wet knickers everytime after she goes to the toilet to urinate. She urinates fine on the toilet and then after she wipes there is a leakage. I have asked her if her vagina is itchy, she says no. I have asked her if it hurts when she urinates, she says no.Do you have any suggestions?Would appreciate any help you can give me.
Answer(s):
It sounds like your daughter may have what is known as vaginal reflux, or urethrovaginal reflux, where some of the urine refluxes up into the vagina, only to leak out into the underpants after the child has finished urinating and moves about. There are several reasons why this might occur, the labia can stick together, and the child's toilet posture doesn't allow adequate separation of the labia during urination. Five-year-olds are rarely able to touch the floor when perched on an adult sized toilet and this may be a contributor to your daughter's problem. Use a stool under her feet and encourage her to sit more upright, with her legs slightly apart, when she urinates.
This problem is surprisinging common in girls before puberty as the urethra is close to the vaginal opening, and the vagina has a more horizontal position and these can be factors in promoting reflux.
An article on this can be found at http://pediatrics..aapublications.org/content/111/1/136.full.html
To be sure that this is the problem it would be useful to discuss this with your GP, and/or contact the public health nurse allocated to your daughter's school. Depending on where you live some physiotherapists work with children specifically around toilet posture and continence issues. A few simple changes and you should start to see some improvement.
