diagnosis requires either identification of the larvae or ova, or a response to a trial of mebendazole Lastly, the provider should give consideration to both sexual abuse and psychogenic dysuria In most of these cases, further evaluation outside of the ED is needed SYMPTOMATIC MANAGEMENT When a specific diagnosis has not been established and the provider is awaiting the results of cultures, therapy directed at the symptom of dysuria can provide some relief Generally, dilute urine causes less irritation than concentrated urine, so a generous fluid intake is recommended Warm water sitz baths may be helpful in the child with urethritis or vulvovaginitis For the child older than years, phenazopyridine (Pyridium) at a dosage of 12 mg/kg/day divided into three doses (daily maximum 600 mg per day), administered for up to days, may be helpful as a urinary tract anesthetic