Bladder Control Problems in Children

A small ultrasound machine detects how much urine is in the bladder before and after urinating to see how well the bladder empties. This quick and painless test is done in the clinic room and takes only a couple of minutes.

This is an easy, painless test that measures the flow and force of the urine stream as the bladder empties. Sensor patches on your child's abdomen and buttocks measure how the muscles work during urination. The test, combined with the bladder scan, also tells us how much urine is in the bladder, how fast and how completely it empties, whether the stream stops and starts, and how much urine is left in your child's bladder after urination.

Some problems with urination are caused by children not properly relaxing their sphincter muscle when urinating. Sensor patches attached to your child’s hip and buttocks painlessly monitor your child’s sphincter muscle activity. To make the process fun and effective for your child, a video game is used to teach your child to better tighten and relax their pelvic muscles. The sessions are typically repeated monthly until your child masters the muscle relaxation. Biofeedback can also help children overcome constipation. 

This nonsurgical treatment helps and may cure an overactive bladder and urinary incontinence. During a session, your child will relax in a chair while elevating one leg. A tiny electrode is inserted in the ankle, sending gentle electrical pulses up the leg to stimulate the group of nerves that control the bladder and block the signals that cause bladder spasms. Initial treatment includes 30-minute sessions that take place about 12 times over several months. Additional sessions may be necessary.

Bladder symptoms are often related to constipation. If a plain X-ray of the abdomen determines constipation is a problem, we can prescribe over-the-counter medications to treat and prevent constipation. For children struggling with frequent or urgent urination or having accidents, medications are sometimes prescribed to relax the “overactive” bladder and prevent bladder spasms. Constipation can be a side-effect of these medications, which is another reason we pay special attention to managing the bowels. Additional medications are sometimes used to promote better bladder emptying.

For children who do not respond to our initial procedures or have more complex issues, urodynamic testing may be recommended. This test is done to define how your child's bladder and urethral sphincter muscles work as they collect, hold, and release urine. This helps doctors discover why a child is leaking urine or having UTIs. 

Your child will urinate into a container that measures how fast it flows and how much is produced. Next, the doctor inserts a small catheter into your child's bladder through the urethra to measure any remaining urine. Then we will fill your child’s bladder with water and X-ray dye. This allows doctors to see how much their bladder can hold, when they have an urge to urinate or involuntary urination, and examine what happens when the bladder empties.

X-rays are often taken during the procedure to provide additional information about the bladder and urethra. Your child will be awake and alert so they can tell us about their bladder sensations.

Botulinum toxin (Botox®) injections into the bladder can help relax muscles and stop spasms in children with overactive bladder or bladder spasms that do not respond to medications. Botox® effects last between six and 12 months and may need to be repeated. This procedure is typically done in an operating room under general anesthesia.

In rare cases, surgery may be recommended to correct birth defects, such as ectopic ureter, or reconstruct the bladder and/or urethra.