Dealing with Getting a 41/2 Year Old Girl Ready for a Urolgist Appt.

My daughter is now 10 and has struggled with overactive bladder and bladder spasms since she was three. First I would call and see what will take place at the first visit. It is less scary for them if they are doing tests for them to have an idea of what might happen. My daughter has had several VCUG's done as well as ultrasounds. I don't wanna scare you, but i have been battling wetting and UTI's for 7 years. My daughter is scheduled to have surgery in July.I am praying this will help her. I have actually been talking with my daughter as she is standing there wetting her pants and she has no idea that she is even going to the bathroom, so I can totally relate to your situatuion. If you have any specific questions, feel free to email me at ____@____.com. I wish you the best.

We had no success at all with potty training out 4 year old (last year) so we took him to the Mayo clinic and there has been lots of urology tests as part of his diagnosis and treatment.

The first time it was loud and very hard to get him to cooperate. Most urology tests are based on putting in a catheter and filling up the bladder. These can feel very invasive.

Some of the tests take picture of the "special water" in the catheter for better x rays, others record the nerve stimulations and signals from probes and stickers places in and around the anus and thighs.

The best thing to do is to explain to her several times what is going to happen on each test and also have rewards and hugs ready.

This is a very good opportunity to talk about good touch and bad touch, private areas of the body and how for some magical reason we subject ourselves to doctors anyways.

good luck-

R. mom of 4 boys and 1 girl (due anytime)

I haven't had time to scan the responses, so I apologize it this is a repeat!

I had bladder troubles starting in infancy...A combination of UTIs and plain old "spastic" bladder (which is just an awful way to say my bladder tells my brain to go even when I don't have to.)

Anyhow, at her age, to avoid unecessary procedures, the urologist might just be satisfied with a bladder ultrasound. Same deal as a prenatal ultrasound, so you should be able to describe the process to prepare her.

If the urologist is more concerned, they may opt to scope the bladder (run a tiny tube+camera into her urethra) which is invasive and uncomfortable even to this 30-something mom who has 2 decades of pap smears under her belt.

I have to tell you, after years of test, x-rays, prescriptions, etc., a solution has never been found for me. As a baby, they diagnosed an immature valve condition that causes bladder reflux and assume I would outgrow it. The upside is that the problems tend to be intermitant...Meaning I can go for a year or two without any problems. Though my urologist maintains there's no need for lifestyle changes, I firmly believe that a few things really help: LOTS of water, no caffeine, avoid spicy foods, avoid citric juices, avoid sugary beverages, avoid soaps (including laundry detergents) with lots of dyes and perfumes, comfy cotton undies...

I have a daughter that has potty accidents. we found out that she needs a laxative twice a week due to constipation. I was wondering if your daughter had a xray to see if she is constipated.

I would call the urology department and ask what specifically will happen during the appointment, will there just be talking or will there also be a physical exam etc?

For an adult appointment, they do a consult and then a physical exam, which is a little like a pelvic exam.

Can you arrange to meet the urologist beforehand, even for a few minutes, so your daughter can have a little familiarity with him/her? Also, is the urologist a man or woman? You might really want to make sure you are scheduled with a woman to help her feel more comfortable.

I have my second consult coming up in a few months for the same symptoms of leaking, so I empathize with your little girl. She probably feels pretty " yucky" down there. Tell her this other lady out here says "I hope you feel better soon."

If you have time, could you let me know by email how the appointment goes? Good luck to you and your daughter.
-jen

Is he/she a pediatric urologist? If so, they are SO good with kids. My daughter had reflux from her bladder to her kidneys causing kidney infections. We were sent to UW Hospital and saw Dr. Kryger. They never did anything to Shelby without expalining everything to me and my hubby. Most of the stuff she had done, she was sedated for. A lot easier on her (AND ME!) If you should have any questions, please feel free to email me.

I guess I wouldn't worry too much about it. We actually just took my daughter to an urologist about a month ago for the same problem. Actually when she turned 5 in April she still wasn't potty trained. We were treated her for constipation after x-rays showed up that there was a high level of stool inside. The medicine didn't seem to be working so I wanted to see if anything else was wrong. She had to go to the bathroom when we got there for a urine sample. When we went into the office he was so nice. When he talked to her he used language she could understand. All he did was feel her stomach really. We decided we should have another x-ray to see if any of the stool is gone and how much as well as an ultra sound to check for incontenence. The urologist didn't want to put her on any medication yet because it could cause constipation and since we were dealing with that already we didn't want to add onto it. He went over Potty training suggestions again - like having her go once an hour (we had tried EVERYTHING up until this point). He did tell us about a watch that had a timer that would go off at an interval we would chose (like every hour) that would vibrate so no one else would know about it. This would be a reminder for her to go to the bathroom to at least try. It has worked great. She doesn't always like to wear it but if she doesn't wear it she may have an accident but when she does wear it she never does. Hope it goes well. If you don't show any anxiety your daughter probably won't either. Just say you are going to find out why you are having accidents.

P.

S. - I don't want to sound an alarm, but do you notice any other symptoms? Most especially, is she thirsty alot? Does her breathe have a sweet smell? Is she more irritable than usual? When my now 12 year old girl was 4, she all of the sudden started having accidents wetting the bed and I like you first thought went the urology route. But. she was also thirsty alot and just not herself... so, I called the pediatrician and said "I want a UA and a blood sugar on Jess, her dad is on the way with her". He ran both - urinalysis was fine... blood sugar was over 700! Normal is 80 - 120. She was immediately diagnosed with Jeuvinille (Type I) diabetes and rushed to Iowa City hospital to undergo treatment for ketoacidosis. Getting a blood sugar on her is super easy - just a little finger poke for a small blood sample on the test strip. So.. like I said, I don't mean to scare you or anything but make sure that the doctors have checked into everything before they just assume that because she's having accidents it must be a urinary issue. Good luck to you! K.

Hi,
My daughter was extremely!!! shy.( A little better now since kindergarten.) She was potty trained early but she would get infrequent bladder infections and could never stay dry all day no matter how hard she tried. She had to see a urologist at 3 1/2. Turned out she was having bladder spasms and the medicine they put her on (although tasting terrible) worked wonders. She only had to be on it for about 6 months and then the spasms stopped. I explained EVERYTHING to her as much as I could for what she could understand. She was supposed to be sedated but there was a mix up. When we got in the room they were about to begin when I asked about the sedation. They told me I'd have to stay for hours to have an anesthesiologist to have time at this point and the procedure wouldn't work as well. (I couldn't stay anyway because my son would be coming home from preschool on the bus before I could get home then, plus I was pregnant at the time and holding my then 1 1/2 year old.) The toughest was the part where they had to put a special device to measure the size of the hole she pees from and have her pee at the same time. I could hold her hand during that part, but not the x-rays that came first. She was very brave but it was traumatic enough that she still remembers that appointment. She's almost 6 now. The doctor and the nurses were wonderful though. They also helped to talk her though it and made her feel like she was special. I would say the most important thing to do is to talk about everything. Find out what is supposed to happen during the appointment and prepare her. The suprise of pain or scary procedures is much worse than knowing there is going to be one. Also, set something up that is fun afterward if you can so that she has something to look forward to as well. Rememeber to tell her how brave she is and be with her as much as you can throughout whatever she is having done. It turned out that nothing was wrong with her and that bladder spasms are a frequent thing they do see in young females which are, more often than not, outgrown. (never knew that) Good Luck with everything!

I would cancel the appointment S. ~ yes, I have been through this. I waited longer, but took my daughter to a lengthy urologist appointment only to find out that her experience was normal.

At the University they tested her for everything, including diabetes.. I finally went to see a Naturepath who explained to me that metabolism and blood sugar levels effect the release of the bladder sphincter. Read on...

The Problem: The bladder releases when blood sugar and hydration levels in the body drop.

Keeping blood sugar levels up is the key to kids sleeping through the night and holding their urine during the day.

Make sure your child is eating a high fat, high protein diet, low sugar diet throughout the day and giving a large high fat/low sugar snack before bed. Water should be given liberally throughout the day and before bed also because dehydration releases the bladder as well (the brain thinks it is starving and blood sugar drops when dehydration sets in).

Bedtime snacks: Cheese with bread or crackers (or just cheese), peanut butter or nut butter with bread or crackers, bean and cheese burrito, fish ~ tuna on toast... what ever you child will eat that is high in fat/protein and low in sugar (make sure your peanut butter is not sweetened).

Water, water, water ~ the more water your child can drink the better.

Perhaps your daughter has had a change in daily eating habits - started a new program with different foods, etc.? What ever has changed, it's time to reign in her diet for the long run. Make her a high-protein breakfast every morning and give her plenty of opportunities to drink water throughout the day.

Then, if her symptoms don't clear up, teach her to Keegel (did they teach you this in birthing classes) to strengthen her pelvic floor). This can be taught right on the toilet - encourage her to stop her pee in mid stream and then let it go again. Each time she does this she will be Keegeling.

My husband is a urologist (although not pediatric), so I asked him. The urologist will probably do a thorough physical exam (the usual stuff doctors check and also looking at her private parts) and your daughter may have an x-ray taken. The main part of the exam will be LOTS of questions: are there any previous medical issues (at birth, has she had any problems walking/learning to walk, etc), has she had a fever/UTIs, how are her bowl movements (constipation would be a common explanation), has there been a recent change in social situation (new school etc). My husband thinks the "worst" thing she might be exposed to is possibly having a catheter placed to get a urine sample, but if she's already been tested for infection perhaps this is not necessary. He doesn't think they'll need to draw blood (not a guarantee, though).

Dear S.,

I think that before you allow a new doctor to examine your daughter, you need to interview the doctor. Also, you may want a second opinion from a different doctor than your regular one.

When I was around your daughter's age, I began wetting the bed and my parents would punish me and scold me...they thought it was behavioral....until they finally took me to my regular doctor appointment where he ran a routine urine test and discovered I had a major kidney infection. Then again, my urine had turned black and from that it didn't occur to my parents that something seriously wrong was going on with my body.

Good luck.

I do not have any advice for you with the urologist appointment but have you thought of taking her to the chiropractor? A lot of kids have been help with bed wetting and other bladder problems. It might help and your daughter might be more comfortable getting an adjustment. If you have any questions please feel free to ask me. A helpful website is www.icpa4kids.org Good luck!
N. G