Diagnosis

Why is it Important to Diagnose and Manage Bladder Problems in Children?

Wetting accidents in school-aged children can cause major stress. If left untreated, they can also lead to bladder and kidney problems for adults. For example, poor bladder emptying, repeat urinary tract infections, kidney or bladder stones and kidney failure are long-term problems that may result from childhood bladder dysfunction.

Often, bladder problems in children are from a bad habit that can easily be corrected.

How is Bladder Dysfunction Diagnosed?

Complete health history: the healthcare provider will begin by asking many questions about your child's health. Expect to be asked about:

  • Birth history, medical conditions, developmental milestones, age of potty-training (how smooth or difficult it was), any house or school stressors (parent's divorce/separation, moving, birth of a new sibling, etc.) 
  • You will be asked questions about your child's bathroom habits such as how often they go, if and when they have wetting accidents, how often they have bowel movements, observations of holding (e.g., squatting, leg crossing, holding genitals if there are triggers for accidents (like laughter or coughing)

Physical exam: your child will be examined in the office. The healthcare provider will examine the abdomen, back and genital area. It helps to let your child know what to expect of this type of exam in advance. During the exam, the doctor will be looking for abnormal physical signs that could lead to bladder dysfunction such as:

  • Girls may have labial adhesions or scarring which can cause wetting accidents soon after using the bathroom. 
  • Boys may have scarring or narrowing in their urethra which can cause a slow stream or a burning sensation. 
  • An anal fissure (a tear in the rectal tissue) or rectal prolapse is a sign of severe constipation. 
  • A large, hard lump in the abdomen may be from stool. 

Tests: the healthcare provider may ask you to take notes of bathroom habits, collect a urine sample, or suggest imaging tests to help make a diagnosis.

  • You may be asked to keep notes in a bladder/bowel diary at home. This is a way to keep track of when your child urinates and passes stool. This will help form a diagnosis and determine treatment options.
  • A urine specimen may be collected during the doctor's visit. This is done to test for a urinary tract infection, sugar in the urine (for diabetes) and to see other elements of the urine.
  • Your child may need a kidney/bladder ultrasound and/or abdominal x-ray. These may be used to find stool in the bowels and help manage constipation, if present.
  • Your child may be asked to urinate in a toilet that has a sensor at the bottom (uroflow). This test checks the quality of the urinary stream. A bladder ultrasound may also be used to check how well the bladder is emptying.