instruction: hello doctor my years old daughter has redness around her vaginal wall it looks as if it is an ulcer type or something it hurts her a lot and frequent urination was there we took her to pediatrician he recommended us ti course zocan and trojan 5 my was given and candid gel is given it has been 10 days but still she complains of leg pain and pain near urethra should we go fo sonography please let me know
output: hello I need more detail history from you whether there is fever or burning micturation or itching around vagina or any discharge from it how is her behavior after these symptoms as you have mentioned that there is cut on vagina how did this cut happen pain burning or stinging when passing urine suspect pain if a young child starts to cry while passing urine the feeling of cannot wait to pass urine may occur this is called urgency passing small amounts of urine at a time often this is called frequency new onset of day or night time wetting pain in the lower tummy may also occur if the kidney is infected the pain is in the flank the flank is the side right below the ribs unis are a common cause of fevers without other symptoms in young children the urine may be cloudy and have a bad odor sometimes there is some blood in the urine ti on top of the list interstitial cystitis vulvovaginitis trauma or injury child abuse the vulva is the area outside the vagina soaps can cause this area to be red sore and itchy this can lead to unis stool that gets on the vulva is another big factor this can happen with careless wiping it can also happen with constipation a rare cause is if the bladder is not emptied all the way reason urine that stays in the bladder too long can become infected cystitis is more common in girls than boys this is due to the much shorter length of the urethra in girls needs urine re a clean catch urine sample needs to be tested a ti is confirmed by finding white blood cells in the urine a positive culture for bacteria is also needed repeat urine s us abdomen ti on top of the list interstitial cystitis vulvovaginitis trauma or injury child abuse ti on top of the list vascicuuretric reflux or obstruction in urinary tract interstitial cystitis vulvovaginitis trauma or injury o child abuse after proper examination and history education clean from front to back after defecation plenty of oral fluids cranberries drinks education clean from front to back after defecation plenty of oral fluids follow up after reports urine and us pelvis and abdomen