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Bed Wetting - Nocturnal Enuresis |
- What is Bed Wetting/Nocturnal
Enuresis?
- How is Bed Wetting/Nocturnal
Enuresis diagnosed?
- How is Bed Wetting/Nocturnal
Enuresis treated?
- 1. What is Bed
Wetting/Nocturnal Enuresis?
Bed Wetting/Nocturnal
Enuresis is persistent, involuntary bed wetting during sleep,
without the evidence of an abnormal urinary system. The widely
accepted view of the cause of nighttime bed-wetting is that the
child has failed to learn to awaken to the bladder pressure and
volume before the bladder automatically empties. By age 6-7 years,
if the problem still persists then treatment should be started.
- 2. How is Bed
Wetting/Nocturnal Enuresis diagnosed?
The urologist
will take a complete history, do a complete physical and exam
the urine. As long as there is no other problems such as urinary
infection, painful urination, stream abnormality, daytime incontinence,
bowel problems or anatomic disorders, most bed wetters become
dry without treatment. Patience and understanding are the best
things of offer.
- 3. How is Bed
Wetting/Nocturnal Enuresis treated?
There are different
treatment options available. The urologist may use a combination
of treatments depending on the individual situation.
Behavior Programs
- Timed Urinating
Program- The waking hours are used to set a schedule to empty
the bladder during specific times. In timed urination, the child
assumes the responsibility for identifying when the bladder is
full and initiates voiding at his/her convenience.
- Fluid Restriction-
Parent(s) are told to restrict the child's fluid intake in the
evening and take the child to the bathroom prior to going to
bed.
- Self-Awakening
Program- Teaches the child to wake-up during the night to urinate.
A self-awakening approach can be tried at any age if the child
is willing. Awakening the parents is discouraged because it takes
away from the child's need to feel responsible for getting up.
- Alarm Conditioning-
The quickest way for a child be become dry is to awaken during
the night to urinate. The goal of conditioning treatment is to
teach the child to respond to their bladder pressure by awakening.
Medications
- The urologist
my prescribe medication as part of your child's plan of treatment.
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- What is Hypospadias?
- Why should Hypospadias
be treated?
- How is Hypospadias
treated?
- What are the possible
complications of Hypospadias repair?
- 1. What is Hypospadias?
Hypospadias is
a birth defect found in boys in which the urinary tract opening
is not located properly at the tip of the penis. There are varying
degrees of severity of hypospadias and several different surgical
procedures to correct it.
- 2. Why should
Hypospadias be treated?
The ability to
stand and urinate is important for boys. When the urethra opens
before it reaches the tip of the penis, a boy may be unable to
stand and urinate with a direct stream. Additionally, as an adult
male, a straight penis is necessary for satisfactory sexual function
and reproduction.
- 3. How is Hypospadias
treated?
Hypospadias is
treated surgically. The surgical procedure for a mild case of
hypospadias may be corrected by a simple outpatient procedure.
Moderate to severe cases of hypospadias may require more extensive
surgery with a stay in the hospital.
- 4. What are
the possible complications of Hypospadias repair?
- Bleeding
- Bladder spasms
- Infections
- Fistula- urine
leak
- Stenosis- a
narrowing of the urethra
- Recurrent Chordee
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- What is an Undescended
Testicle?
- How is an Undescended
Testicle diagnosed?
- How are Undescended
Testicles treated?
- What are the possible
complications?
- 1. What is an
Undescended Testicle?
An undescended
testicle is a birth defect found in boys in which one or both
of the testicles are not properly positioned in the scrotum.
Sometimes the testicle will come down on its own by the age of
one year.
- 2. How is an
Undescended Testicle diagnosed?
The initial evaluation
will include a thorough history, physical examination, and inspection
of the child's testicles. Sometimes, ultrasound or other imaging
tests may be performed. There is a need for concern with an undescended
testicle. Permanent damage can occur, resulting in scarring and
poor sperm development.
- 3. How are Undescended
Testicles treated?
There are two
options, non-surgical and surgical. The non-surgical option is
a series of hormone injection treatments. This is effective in
about 30% of the cases. The other option is surgical. The urologist
will perform an outpatient procedure, where he will bring the
undescended testicle down into the scrotum.
- 4. What are
the possible complications?
There are a number
of possible risks associated with any surgical procedure. Some
of the more common are:
- Bleeding
- Infection
- Atrophy- the
shrinking of the testicle
- Infertility
- Re-ascent- the
testicle may move back up into the body.
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Urinary Tract Infections (UTI) in Children |
- What causes a UTI?
- What are the symptoms
of UTI?
- How is a UTI diagnosed?
- What are the treatments
for a UTI?
1. What causes
a UTI?
An infection
occurs when bacteria enter the urethra and start multiplying.
If the infection stays within the urethra, it is called urethritis.
If the infection enters the bladder, the infection is called
cystitis. The infection will sometimes involve the prostate,
this is called prostatitis. Last, the infection can go into the
kidneys, this is called pyelonephritis. UTI's can occur in infants
and children who are born with urinary tract abnormalities, some
of which need to be corrected with surgery.
Normally, the
act of urination will wash the bacteria out of the urethra to
help prevent infections.
- 2. What are
the symptoms of a UTI?
- Frequent urination
- Urgency of urination
- Burning during
urination
- Pain in lower
abdomen
- Pain in back
or side
- Frequent urination
at night
- Pelvic discomfort
- The urine may
appear:
- Discolored
- Cloudy
- Brownish or
reddish
If the kidneys
are involved:
- High fever
- Overall bad
feeling
- Nausea
- Vomiting
Children also
can consist of:
- Irritability
- Abnormal eating
pattern
- Unexplained
fever
- Loss of bladder
control
- A change in
the child's urinary pattern
- 3. How is a
UTI diagnosed?
- A "Clean
Catch" or catheterized urine sample.
- 4. How is a
UTI treated?
Urinary tract
infections usually require treatment with antibiotics that are
often selected according to the sensitivity test done in the
office. Most UTI's are treated with short courses of antibiotics
usually only one to three days. However, some infections require
treatment for one to two weeks.
Treatment of
urinary tract infections involve not only an antibiotic but also
measures to alleviate the discomfort that may be caused by a
UTI. Warm tub baths or sitz baths can often be beneficial as
can heating pads. Avoidance of urinary tract irritants such as
caffeine, alcohol and spicy foods can also help alleviate some
of the symptoms.
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