About the Healthy Bladder Clinic
The Healthy Bladder Clinic is a subspecialty of the Division of Pediatric Urology at Cincinnati Children’s Hospital Medical Center. Our Healthy Bladder Clinic is devoted to caring for children who have various bladder and urinary tract complaints. Our program evaluates and treats hundreds of children with daytime and nighttime wetting. We also see children with urinary symptoms such as frequency, urgency, painful urination and recurrent urinary tract infections.
If your child is experiencing any of these complaints, you should discuss this with your pediatrician or family practice physician.
Daytime Wetting (Diurnal enuresis)
Children after the age of toilet training (between 4- 5 years old), can have wetting accidents during the day. Some of the common causes of daytime wetting include constipation, bladder spasms, infrequent urination and urinary tract infections.
Daytime wetting can happen when a child is attempting to run to the bathroom (urge incontinence), during exercise (stress incontinence) , while laughing (giggle incontinence) or immediately after urination (post void dribbling) .
Nighttime Wetting (Nocturnal Enuresis)
Bedwetting tends to run in families and is considered genetic in most cases.. A child can have nighttime wetting or bedwetting since toilet training or it can occur after a child has been dry at night for several years. Bedwetting is common in children through age 5 and not considered abnormal unless daytime urinary symptoms exist.
Punishment is not recommended or helpful in treating bedwetting. Punishment can only contribute to the child’s poor self esteem. Achieving dryness through supportive and positive treatment is more beneficial and helps contributes to improving the child’s self worth.
Our Team
Our Healthy Bladder Team includes four nurse practitioners and a pediatric nephrologist. A pediatric nephrologist is a doctor that specializes in the care of children with kidney and bladder disease. Nurse Practitioners are registered nurses with an advanced degree and special training. These individuals work with the urologists at Cincinnati Children’s Hospital to provide excellent care for your child. Your child can be scheduled in the Healthy Bladder Clinic at one of our various locations at the Main Hospital, Liberty, Anderson, Mason, Fairfield or Kentucky.
First Appointment
When you and your child come to the first appointment, the nurse practitioner or the physician will take a very complete medical history. Your child will also have a physical exam. A urine sample will be obtained. It is important to complete the urinary and bowel diary that you receive in the mail prior to your visit. This simply requires you to document how often you child urinates and has bowel movements.
To make an appointment you can call the Call Center at 513-636-4975, Option 1. Please check with your insurance company, you may need a referral from your primary care provider
Diagnostic Testing:
- Kidney Ultrasound
- Kidney Ultrasound: Follow-up
- Non-Invasive Urodynamics
- Nuclear Cystogram
- Voiding Cystourethrogram
- Non-Invasive Urodynamics Test
After your child has been examined, some testing may be recommended. Some of the common tests that are ordered are:
- KUB- This is a quick and simple X-ray of the abdomen. This test can determine if your child is constipated.
- Renal Ultrasound- This is a painless procedure that can measure the size of the kidneys. Also the bladder can be evaluated with this test for abnormalities.
- Uroflow (Non Invasive Urodynamics)- With this simple test, your child urinates into a special toilet that will help evaluate the quality of his/her urine stream. After urinating, a special ultrasound test will be done on your child’s bladder. This part of the test is to measure the amount of urine left in the bladder.
- PVR (Post Void Residual)- This quick ultrasound is done in the office. After your child urinates, the nurse will apply a clear gel on your child’s abdomen. A picture will then be taken of the bladder to measure the amount of urine left in the bladder after voiding. This test is often called the “jelly belly” .
Treatment
After your child’s visit and testing, a treatment plan will be recommended for them. Each child is different and each treatment is developed for the individual needs of that particular child. Treatment may include medications, behavior changes, biofeedback, bowel program and positive reinforcement.
Healthy Bladder Habits:
There are some simple habits that are recommended for children with a urinary complaint.
1. Increase Fluid Intake: Throughout the day It is important that your child drink water and healthy fluids. If your child is wetting the bed, it is especially helpful to drink large amount of fluid early in the day and while at school.
2. Voiding Schedule: We recommend that children with daytime wetting and urgency, use the bathroom every 2 hours.
3. Relax when urinating: Girls should pull tights and slacks down to ankles so as to spread their knees wide apart. Boys should stand with their feet shoulder width apart while urinating .
4. Bowel Program: It is important to have daily bowel movements when there are bladder complaints. A diet with plenty of fruits and vegetables is recommended. Also your child should attempt to have a bowel movement everyday. They should be unhurried and relaxed while attempting a bowel movement.
