Treatment

Treating Bladder Dysfunction

Managing bladder dysfunction in children is often successful. The first step is to learn which type of bladder problem your child has.

If your child has constipation then treating it by helping your child to have regular bowel movements can, by itself, cure bladder dysfunction.

High-Fiber Dietary Changes: Offer meals with many fruits, vegetables, and whole grains.

  • Products are available to increase daily fiber intake, such as "Fiber Gummies". 
  • For the short-term, your care provider may recommend a bowel cleanse.

If your child does not have constipation or does not respond to constipation treatment, other treatments will depend on your child's diagnosis.

Children who void infrequently or seem to wait until the last moment to go, may have urgency and wetting accidents. Creating a timely bathroom schedule can help.

Scheduled Voiding: with this method, you help your child follow a daily schedule of going to the bathroom which can retrain the bladder and sphincter muscles.

  • Your healthcare provider may suggest a bathroom schedule for your child of every 2 to 4 hours, whether they have to go or not.
  • If your child is old enough to wear a programmable watch, it can be set to vibrate or make a sound to help stay on schedule in school.

If your child has frequency of urination, or going too much, they may have daytime accidents when a bathroom isn't nearby. Children in this case may have an overactive bladder (a bladder that holds less than it should and it must be emptied very often).

Medication for Overactive Bladder: can help your child's bladder to hold more urine, for longer.

  • Examples of these medications include oxybutynin and tolterodine.

Medication for Giggle Incontinence:
Examples of these medications include oxybutynin or methylphenidate (Ritalin).

Some children may have problems with the way their bladder contracts, and the way their sphincter relaxes. In this scenario certain pelvic floor exercises can help.

Pelvic Floor Exercises: different exercises help different problems.

  • "Quick flicks" are useful when a child has the "gotta go" feeling too often. The exercise is done by squeezing and then relaxing the sphincter and pelvic floor muscles as quickly as possible, several times, when they feel the urge to go. This sends a message to the nervous system and back to the bladder to stop squeezing. As the bladder stops squeezing and starts relaxing, the "gotta go" feeling should lessen. 
  • "Kegels" help strengthen the pelvic floor muscles. Kegels are done by squeezing and relaxing the pelvic floor muscles many times each day. Children can do this while they urinate to start and stop the flow, and gain control. Pelvic floor muscles help support the bladder and other organs. Exercising them can make them stronger and help reduce leaking. 
  • Your healthcare provider can explain pelvic floor exercises and which type will help best.

Biofeedback Therapy: may be offered in your child's doctor's office. It teaches children how to control their sphincter and pelvic floor muscles.

  • Biofeedback therapy uses video games that interact with electrode skin patches placed over the sphincter area. After a few sessions, your child will be able to recognize and control these muscles.

Children with leaking accidents just after using the bathroom (post-micturition dribbling) may be girls with labial adhesions and/or are overweight. In this case, the child will be asked to spread her legs when seated to release more urine. Weight loss may also help. If there are adhesions, a two-week course of estrogen cream can heal the area.

With a clear diagnosis, you can work with your child's healthcare provider on a helpful treatment plan.