The Voiding Improvement Program specializes in helping children with daytime urine incontinence, bedwetting (nocturnal enuresis), urinary urgency and urinary frequency. We also see children with recurrent urinary tract infections (UTIs) and constipation. These are all different types of voiding dysfunction, and our team will work closely with you and your child to develop a plan to help your child achieve normal bladder and bowel function and stop accidents from occurring.
Diagnosis and Evaluation
Our team has access to state-of-the-art technology and a wide range of resources to properly and accurately diagnose voiding dysfunction in children. These include, but are not limited to:
- Urinalysis and urine culture
- Ultrasound of the kidneys and bladder
- Uroflow with or without electromyelogram (EMG)
- Post void bladder volume measurement
- Xray of the kidneys, ureter, and bladder (KUB)
Treatment for voiding dysfunction in children can vary widely and depend on the age of the child, the frequency of the problem, and whether there are underlying medical problems. Treatment always begins with behavior modification strategies, such as timed voiding, limiting fluids before bed and controlling constipation, if present.
For nocturnal enuresis (bedwetting), other treatment options include the enuresis alarm or medication to treat the symptoms of bedwetting. For daytime urinary complaints, control of constipation is key, and some children may need the addition of biofeedback therapy or medication. Biofeedback is specialized pelvic floor muscle retraining that uses games and visual feedback to teach children to control their urinary sphincter through contraction and relaxation. This is performed by our specialized nursing staff in the Urology Clinic. Some children benefit from pelvic floor physical therapy in combination with strategies used in our clinic.
It is important that we measure the outcomes of our treatments so we know how well they are working and if our patient’s symptoms are improving. Outcomes information is also important when families are seeking care and providers need to make referrals. To track our outcomes and the progress of each our patients we use a validated symptoms questionnaire. This short questionnaire is given to each new patient and at each follow-up visit. We can track improvement with decreasing scores on this questionnaire. These scores also give patients and families objective feedback to measure their success.