For many children, frequent urinary tract infections and urinary accidents signal a more subtle health problem known as voiding dysfunction—a condition used to describe urinary habits that are unhealthy.
Along with urinary accidents during the day or night and/or recurrent urinary tract infections, children with voiding dysfunctions may have other symptoms, including:
Problems with voiding can be linked to children’s anatomy, physiology or bathroom habits. Whatever the cause, proper diagnosis and treatment can resolve even the most serious voiding dysfunctions.
Possible physical and anatomical causes for voiding dysfunction are:
Possible behavioral causes for voiding dysfunctions are:
The Children's Continence Program at Riley at IU Health specializes in evaluating children for voiding dysfunctions. Our pediatric urologists and nurse practitioners are expertly trained to find and treat the root of your child’s recurring incontinence and urinary tract infections. Many families are referred to Riley at IU Health after other treatments have not worked—otherwise known as refractory dysfunctional voiding.
Our specialists gather a medical history to better understand your child’s overall health, voiding habits and bowel function. We also collect a social history to gain insight about your child, including eating and drinking habits. Your child will also have a physical exam and lab tests, including urinalysis, urine culture and possibly blood work.
Based on your child’s evaluation, your physician may recommend additional tests that are appropriate for making an accurate diagnosis. These may include:
Your child will be in expert, compassionate hands while being diagnosed and treated for a possible voiding dysfunction.
Diagnosis and treatment for incontinence relieves a great burden for many families. Low self-esteem and emotional stress often affect children who cannot hold their pee. Understandably, parents may find their child’s incontinence and suffering equally distressing.
Fortunately many children with voiding dysfunctions respond to modest treatments, including behavioral modification and training to help them acquire healthier voiding habits. Our specialists help families apply simple techniques that may resolve incontinence or other voiding dysfunctions.
Children can improve voiding by:
These behavioral changes may be supported by medication, physical therapy or biofeedback to educate the muscles of the pelvic floor. Medication can be useful for calming muscles that stimulate an overactive bladder. Since incontinence often goes hand-in-hand with constipation, we may also treat constipation, which can further irritate the bladder. Some families use bed alarms for nighttime bedwetting and bathroom timers as reminders that it is time to go to the bathroom.
If incontinence is linked to a child’s anatomy, surgery may be an inevitable part of treatment. Pediatric urologists at Riley at IU Health rank among the top providers in the U.S. for treatment of voiding dysfunctions related to body structure, including vesicoureteral reflux—a condition that causes urine to flow backwards in the body. This can cause frequent urinary tract infections with high fevers that can damage kidney function.
Riley at IU Health also serves a small population of children with voiding dysfunctions that do not respond to standard treatment or conservative therapy. For these children, we offer a specialized form of therapy called sacral neuromodulation. This treatment stimulates nerves in the bladder, improving bowel and bladder continence.
The procedure works by placing a device under the skin in the lower back to stimulate a specific nerve that controls bladder and bowel function. The device delivers electrical impulses to the nerves, telling the bladder or bowels when to contract. After families explore all other options without success, sacral neuromodulation can provide much needed relief and is successful in approximately 75 percent of these difficult cases.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This institute is part of the U.S. Department of Health and Human Services. It supports medical research through universities and medical institutions in the U.S. and provides health information about diabetes, digestive and kidney disease.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
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