Pediatric Toileting Problems
Toileting problems can lead to embarrassment and frustration for both child and family. Some children struggle with wetting accidents long after their peers. Amy Irene offers positive treatment for children with voiding dysfunction including:
- Night Wetting: While voluntary voiding control begins at 2-3 years old, children should have full bladder control by age 5. 19% of 5-6 year olds still wet the bed. 10-25% of children that wet the bed also wet during the day. “Dry Bed Training” is an effective treatment with a 92% success rate. This positive treatment program involves bladder retraining, training of pelvic muscles to improve control, and dietary modifications.
- Bladder Urgency: Some children struggle with bladder urgency and small bladder volumes that can result in embarrassing day time leakage. Physical therapy treatment including dietary modifications, bladder retraining, and training of the pelvic muscles can help. Using these treatment techniques, the child can learn to calm the bladder, increase time between urinating, and have success being the boss of the bladder to stay dry.
- Vesicoureteral Reflux (VUR) occurs in 1% of children and causes urine to back up into the kidneys. VUR is often caused by a structural problem and symptoms can be worsened by poor toileting habits. Children with VUR get reoccurring bladder infections causing pain and fear of urination. Delaying urination, holding urine too long, and large bladder volumes worsen reflux into the kidneys and can lead to kidney damage. Physical therapy treatment to help children with VUR includes toileting retraining, learning to relax pelvic muscles, behavioral modifications, dietary modifications, and family support.