Any medics out there? 3yo girl with discharge, no infection - what next?

[Highlove]

Been back and forward to the GP with my 3yo DD over last couple of months. She had been reliably potty trained for months and months and was dry most nights but has started having lots of little accidents and is wet every night. A couple of times I've noticed her being quite smelly underneath, though she bathes or showers daily. And sometimes she has a discharge in her pants - yellowed and thick, definitely not just wee. Once she's said it hurts to wee but when I've asked her (a few times!) she's saying it doesn't hurt. She's had her urine tested three times (twice sent to hospital lab as well as dip-tested) and two vaginal swabs. The urine has a couple of times come back with minute traces of protein and white blood cells, but the lab say it's not a UTI. She's also had a blood sugar test; all fine.

For tedious reasons we ended up seeing a paediatric (SP? Sorry!) registrar in A&E recently who mused over her maybe having vulvovaginitus (first mention of it by anyone and I had to google it to see what it was!) but unhelpfully wouldn't examine her and told me to go back to my GP if it continues and maybe she'd need to see a paediatrician to diagnose it formally. Anyway, she's had discharge again the last few days so I'll take her to the GP again tomorrow and that'll be about the fifth time she's been.

I'm at a loss as to what to do/say to the GP. Do I push for a hospital referral and who does she need to see? Is there anything else it could be/I should be pushing them to consider or test for?

My poor little girl obviously has something up and I just want to help her get better. Help!

I'm sure it's already been ruled out but it's not something as simple as threadworms is it? They really messed my daughters bits (front and back) up.

Vulvovaginitis simply means 'inflammation of the vulva and/or vagina'.

I'd stop asking her, but observe behaviour.
If she is not scratching herself/does not have her hands in her knickers/does not bumshuffle around, she is unlikely to be uncomfortable..

Little girls can have physiological discharge - normal secretions from the glands in the lining of her front passage. With all the normal tests she has had that is the most likely scenario and does not require any kind of further investigation or treatment.
The multitude of tiny microorganisms which quite normally live in the vagina and the bowel normally keep each other in check but sometimes they can get 'out of balance' and cause a bit more discharge and/or smell. This is quite a common problem in recently potty trained children.
Nothing at all to worry about.

Don't over wash - no more than once a day.
Do NOT wash inside her - flat hand between her legs is fine, use a gentle soap, nothing too smelly/bubbly.
Cotton underwear, changed daily.
If things look irritated consider using a nappy cream/barrier cream for a few days.
Leave her be otherwise and don't mention anything to her.
If she behaves her normal self, then trust that.

Oh, and, of course, if you have ongoing concerns take her back to your GP and don't take an internet stranger's word for it

She still goes in the potty mostly so I'm guessing if she had worms it'd be obvious?

pacific thanks that is super helpful. I've not noticed any sign of her scratching or fiddling. But what about the wetting? I guess it could be unrelated but it's weird - she had been totally reliable for over six months, including at nursery. And now it's most days. Rarely full, all over the floor wees but big dribbles. And wet overnight again.

Vulvovaginitis is incredibly common in primary school aged girls and clears up by itself by puberty. It doesn't need anything other than the simple everyday things you're already doing unless it gets significantly worse, there is any bleeding or your daughter complains of it being consistently painful. You just need to make sure she wears cotton underwear, isn't left in anything damp like swimwear for too long, don't use perfumed soap on her vulva and let her have some pants off time every now and then. If it's worsening see your GP but otherwise you're doing all the right things.