Please tell me your experience - little girl's UTI and doctor visit.

[Tohru]

I guess I'd like to know if checking little girl's private parts when they have a UTI is normal doctor visit procedure?

 

I took my 5yo to see a new doctor's office because she showed signs of a bladder infection.  My mom gets them often and my daughter was doing all the things my mom complains about. 

 

Anyway, the test came back more than likely positive.  Our visit wound up being with the Physician's Assitant, who I actually thought was the Dr. until the end.  This was our first visit.  It seems seeing the PA is normal for this office. 

 

He did an examination (eyes, ears, throat, pressure points) and my daughter said it hurt when he applied pressure to her lower belly.  Then he told me he had to check my daughter's privates.  I was pretty shocked, but this was our first experience.  I've never had to deal with a UTI before.  He explained he just needed to see if there was redness or swelling and it was a quick external exam.  I really didn't want to give permission and even argued with him about it for a bit, but in the end, I reluctantly agreed.  It was very quick, but still happened.  My daughter was terrified and crying.  I felt horrible.

 

Afterward I came home and have been scouring the internet to see if that procedure is normal, but I can't find any information that justifies it. 

 

So please tell me, if you have experience with a little girl's UTI, what generally happens in the doctor's office?

 

Thanks.

 

[sparrow]

My dd had a very serious UTI that she was nearly hospitalized with when was 4 years old.  She saw several doctors, because they originally thought she had food poisoning, then a virus, and finally a UTI was diagnosed, but they never examined her down there.  I don't know if that's typical, or not.

 

 

[zoobie]

That sounds routine to me. My DD got them frequently, and IIRC (it's been 6 years), they did an external check both for infection and deformities. We wound up doing the test for bladder reflux with her through a pediatric urologist (she also did an external check during the office visit), and that test was highly unpleasant. Did you mention the family history of UTIs? The worst part of the doctors visits was trying to get her to pee in the cup!

 

Our ped also does the external quick check at annual physicals, so it's not abnormal to the kids. For boys, they check for hernias. Has yours never done them? They always mention that no one is allowed to touch there other than a doctor for medical reasons with a parent in the room.

[Harriet Vane]

I have not had experience with a little girl's UTI. However, it is becoming increasingly common for a dr to expect to include the genitals in routine physicals. I suspect that he had to check the area both to check for signs of infection and for signs of abuse. I have never allowed checking that area during a routine physical, but if there were actual symptoms (as with your dd) I would most likely allow the dr to check. That said, I would probably want a female dr, simply for my dd's comfort level.

[Lady Marmalade]

Wow.  My DD had a UTI when she was 4, and there was no physical examination of that area. They checked the usual things and then DD needed to produce a urine sample.  That was it, a few lab tests later she was on strong antibiotics as it was a particularly nasty strain.

 

The doctor did ask the usual probing questions, has anyone touched you there, etc.  But there was no physical exam.

 

However, this was 8 or 9 years ago, things may have changed.

[Jean in Newcastle]

It seems routine to me.  They need to see if there might be a problem with yeast down there as well as possible other problems.  Shouldn't be anything to cause terror.  

[Tohru]

Oh a flood of relief!  Thank you so much!  We just switched doctor's and everything was so new to us.  I appreciate the comments saying it sounded routine.  It made sense when he was arguing with me, but I just didn't want to especially becuase I had just told her about her "No-Zone" last week.  Thank you for easing my mind.

[Jean in Newcastle]

The "No zone" talk should have included it being ok for a doctor to look when Mommy said it was ok.  

[Parrothead]

Dd had one when she was 6. There was no looking anywhere clothing covered.

[TCB]

Pretty routine in my experience. They need to check for any deformities that may be pre-disposing a child to UTIs and also make sure inflammation is not causing problems. I don't think that the reason for checking is primarily looking for signs of abuse but may be a secondary reason. I think kids really pick up on their parents emotions and she may have been picking up on some of your discomfort but I'm sure you already are aware of that. I try to act as if things are just no big deal during a doctors visit if at all possible even though at times it is difficult. I'm fairly sure that our Ped also mentioned to dd that only a dr with parents permission should look at their private parts. My dd has had to be checked several times, she had reflux to left kidney, and she seems to have come out of it pretty unscathed. Hope th eUTI clears up quickly. Don't let it put you off getting checked again if she gets another, it is really important to get it checked because recurring UTIs can cause damage to the kidney.

[*********]

Well, the only experience I have is when I had a UTI myself a few years ago. I had to go to urgent care; dr was closed. The urgent care doc did not do any exam of my privates. Just external exam stuff and a urine sample.  But I can totally see why a ped. might do one to rule out some sort of structural issue.

Gently said, the fact that you argued with the dr about it and *then* agreed to it likely added to your daughter's upset reaction. I'm not trying to judge; you have every right to refuse medical care on her behalf. Just in the future, I'd either allow or disallow something, period. Kids pick up on our indecisiveness/stress.  I'd try to remember to start with just asking more questions, like asking the doctor to explain why it's necessary to do an exam, etc, instead of starting with "no", and then letting him talk me into it.

I'm only sharing that because I've done the same general thing to my son. I had to take him to the ER for what turned out to be pneumonia. They were doing tests, and wanted to give him a nasal swab for flu. I initially refused; it's not just a q tip up the nose; they have to jam that thing all the way up into your sinus cavity. He was very sick, had already endured an iv, and I really didn't think it was the flu. We were waiting on x-ray results to confirm pneumonia. I asked the nurse why she wanted to test him for flu, and she said it was just to see if he was positive or not; he had already been sick too long for any antivirals to help. I just didn't want to put him through it unnecessarily, so I told the nurse no. Wow, my son was so relieved! But then in comes the doctor, who says they needed him tested because they were going to admit him, and they needed to know if he had flu in addition to his pneumonia because that would help them determine who to room him with; can't put non-flu kid in with a flu kid. Man, now it made sense, but BOY OH BOY was my son even more upset than he even would have been if I had let the nurse go ahead and swab him in the first place. He thought he had escaped the nasty brush up his nose for SURE. I felt awful. I should have asked more questions, but hindsight is always 20/20.

Really, I don't mean to make you feel bad. I even hesitate to post this. But if it helps someone else's and their kid, well...

[Loowit]

DD had one UTI and yes they checked.  It wasn't a big deal.  They always did a quick check at all her well visits too.  That is how we found out she had fused labia that was causing problems and got it treated.  I am sure all doctors have different routines that they follow when checking this stuff.

[DianeW88]

Yes, it is normal for a UTI.  He needs to check for any structural abnormalities, adhesions, signs of external infection, etc.  It's not uncommon at all.  This is also part of an annual physical exam as well.

[Supertechmom]

Routine here for UTI and annual physical.  Dr explains exactly what they are going to do and that no one else can do this and she is only because she is the doctor making sure they are okay and mom is right there.  UTIs are often from bacteria and a quick peep may show if it is unusually red or irritated or sometimes the area sticks to itself and there may be infection under the skin that has grown up together.  Double checking to make sure there isn't an obvious area of infection that could be causing the UTI only makes sense.  Then you can treat the source and the UTI and knock them out the first time instead of growing some resistance bacteria. 

[Ottakee]

I would say it was normal.  We had a foster daughter who did have a physical abnormality that was causing her to have the UTIs.  The calmer and more matter of fact you can be the easier it is on the child.  You can always request a nurse be in the room as well when the doctor does the exam if it makes her or you more comfortable.

 

If she does have another UTI I would request an appointment with a peds urologist to find out what is behind them.  Frequent UTIs can signal problems such as reflux or other things that can lead to kidney damage down the road.

[Carrie12345]

Our ped practice checks.

[Tap]

Yes, it is common and yes, my daughter had a quick exam with a UTI.

 

 

Here is the thing.  There are multiple causes of this type of pain.  Some doctors want to save embarrassment and just use the test to identify the infection and then treat it.  No matter what is causing the bacteria in the urine, it will need to be treated, so an exam most likely won't change the need for a urine test...and a positive test will result in an antibiotic. 

 

If the test came back negative, then they may have the child come back to the office for a physical exam.....and possibly more testing. 

 

By just doing a cursory glance at the area, the doctor can check for external causes and make a better diagnosis.  

 

 

[PinkyandtheBrains.]

A quick check of the external area to see if there is irritation is common, our Ped does that with my boys too when they have signs of a UTI.  Children often get them from external factors such as poor hygiene, bubble bath and other irritants. 

[catz]

My son had a UTI once and yes, he did get an external exam. Actually, if that would have been the end of it, I would have been thrilled. We had a very bad experience with it and the dr. ended up ordering tests that we had to pay for out of pocket because insurance deemed them unnecessary. I have refused to see that doc ever since.

[Guest submarines]

When DD had a UTI when she was 4 the doctor simply asked me if there was any redness there. I like when doctors treat their patients as people who have feelings.

[mamaraby]

We just went through this earlier in the yr with my 3yo. In our case the only indication of UTI was red blood cells in her urine. Her urine samples never cultured out with any bacteria and because of her age we ended up with both an u/s and a visit to a pediatric urologist (outptient hospital visit b/c of the clinic's location meant deductible plus coinsurance percentage). With both our family practice doc and the pediatric urologist, an external exam was part of the visit. And yes, they're looking for abnormalities like a labial adhesion which can provide urine with a place to pool and the end up back in the urinary tract causing infection.

 

In our case, a series of external exams over a period of several weeks when the red blood cells and dds discomfort continued was enough to save us from the VCUG and instead pointed to an external source. I for one was glad not to go through the highly invasive, under anesthesia VCUG.

[magnificent_baby]

It is a normal part of an annual exam at my kid's office. I would assume it would be for a UTI. In my nursing experience in ER, it most definitely would be a normal part of an exam for any age patient. This is partially why my Dd9 decided to switch to a female pediatrician this past year. I always gave her the option and let her decide when she was ready. 

[Catherine]

A child's genitals would be checked but not an adult's, because congenital anomalies that may predispose to UTIs would be possible in a child, not expected or likely in an adult. It should be a routine part of any evaluation of a boy or girl who first gets a UTI. In fact any boy who has a UTI should have other testing done to determine the cause.

[SKL]

Can't read all the replies, but here's my reaction.  One, the doctors looked at my kids' genitals as a routine thing (well visit) up until they were about 3yo.  I thought it was weird, but it did not really bother me since I was right there.  After the 3yo check, it was not done routinely and I would not have liked it if they did that.  Little girls are entitled to their privacy at some point.

 

That said, a UTI could be a symptom of sexual abuse, so honestly, it would not surprise me if they checked.  If the mom is right there watching, I don't see it as a problem.

 

My kid had a similar office visit (suspected UTI) at 5, and I honestly cannot remember if they looked at her privates or not.  I'm thinking not, because I think I would remember something like that.

[Paige]

My DDs get frequent UTIs and there is typically a visual check. Occasionally, the visual check has turned up something like a yeast infection or a cut that we also needed to treat. An antibiotic alone would not have been enough then.

 

I find that visual checks are more common for the 5 and under crowd and it makes sense. I don't recall my 9yr old having a visual check for UTIs recently, but she's a more reliable reporter now. My 5yr old still gets checked. I think if a child is complaining of pain when she pees, then it makes sense to see if something is there. If the doctor asked me if there was redness, I wouldn't know. I'm not in the habit of looking at their privates after they take over their own bathroom and bathing needs.

[SKL]

I am honestly curious as to why a parent would not want a 5yo's privates to be looked at if the doctor suspected a UTI.  Assuming the parent is right there watching everything.

[Lilaclady]

My ped does a quick glance at their yearly checkup. I already including it in their no touching that drs can look if a parent is in there with them.

[Joanne]

I would absolutely expect a routine, quick check of the genital area for a UTI. For many reasons, one being the *infection* part of the UTI.

 

I'm not sure why a child of school age would be that scared, a routine check of the genital region is part of annual exams.

[Melissa in Australia]

 DO they look at adults privates for UTI as well? They don't here (AUS). Here all they do is a urine sample.

The only times I have ever had to show a Dr those parts is for a pap smear or delivering a baby.  None of my children have had to show that area to a Dr. ever

[SKL]

I remember when I was a kid, maybe 10yo, and I went to the doc for suspected UTI.  I remember that they looked at the area and even cleaned it in prep for the pee sample.  I know a lot has changed since then, but I don't remember being traumatized at the time.

[TeenagerMom]

Both of my DC are always checked at their annual exams (by their female Ped) and have been checked by specialists also (female and male). Totally NOT a big deal.  I actually prefer they "get used" to their physicians requesting to see their private areas during a routine exam to help prevent the mortification and shame that many, many adults feel when they have to discuss something in their nether regions with their Physicians.  

[J-rap]

I agree with others that a quick visual check at a young age may be called for since it's very possible that structural problems have not been picked up yet. I think if you can be calm and matter-of-fact about it with your daughter, she will hopefully relax about it as well. (I know that's not always easy!)

 

One of our daughters had reflux to her kidney, and began having UTI's at 3 months! It can be very dangerous, and if it hadn't been picked up quickly it could have resulted in permanent damage to her kidney. Another daughter had a UTI at around age 7, and because her sister had reflux she was tested for it (not pleasant). Thankfully she didn't have the reflux.

[Alte Veste Academy]

I think it is perfectly normal and fine that he would examine her in that way. What (potentially) bothers me is (my assumption) that he didn't offer you the option of having a female practitioner (if available) do the exam instead. Because you say your DD was "terrified and crying" I am also wondering how he spoke to her--if he was matter of fact or if he took the time to explain himself patiently to her. At 5, my kids were all perfectly capable of understanding when a medical procedure was beneficial/necessary. I do agree that you "arguing" about it was probably a contributing factor for her anxiety, but once the anxiety was obvious, pains should have been taken to help her calm down, before the exam began. As I said, I would have allowed it, but I would not be OK at all with a doctor/PA proceeding with an exam of that nature while my daughter was scared and in tears. Obviously, I do not know anything about his bedside manner, but even if he was just as kind as can be, I still would have wanted some time to attempt to help her calm down.

 

Also, my kids haven't had an exam of that nature since their toddler years, so obviously it is not universal practice for yearly well child check-ups. I can understand why a child would be scared if it was the first, especially if the practitioner was all business instead of personable (which, obviously, I don't know).

[NatashainDFW]

I am honestly curious as to why a parent would not want a 5yo's privates to be looked at if the doctor suspected a UTI.  Assuming the parent is right there watching everything.

 

If my daughter is uncomfortable with the situation I refuse to force it on her unless ABSOLUTELY necessary and not without calmly explaining the need and making sure she was comfortable. Granted since she was about 9 months old no doctor has asked to look anywhere clothing covers. The one time she has had any pain while going to the bathroom I asked her if we could take a look. Turns out she wasn't wiping well enough. I gave her some diaper rash cream to apply herself and reminded her repeatedly about wiping really well. Within about 12 hours she was fine. I can say if it wasn't that simple I would still expect her wishes for her body to be honored. She is a very aim to please type child though and if there is a real issue her father and I could explain why and she most likely would agree to the check but under no circumstances would I allow a check of her body if she was that upset. I would at least ask the doc to step out while I calmed her and explained the need.

 

ETA: I expect the same respect be given to my boys as well. 

[kiwik]

Seems ok to me. I only have boys though and they seem to get looked at quite often. The doctor doesn't touch once they are old enough to co-operate though.