Continence problems in children are extremely common. Many primary care providers are comfortable and willing to address them. However, sometimes these problems are refractory to routine interventions or are persistent and complicated. We see children with continence problems, daytime, nighttime, and both, from complex to simple, every day. Evaluations will include the evaluation of a urine specimen to rule out urinary tract infections or blood in the urine and an ultrasound to ensure good bladder emptying. Most importantly, a thorough history will be obtained, and a physical exam will be performed. The history is usually the most important factor in the evaluation of children with incontinence. We will ask many questions at these visits, including how often the child voids, when the incontinence occurs, how much urine is leaked, treatments that have been tried previously, whether urinary tract infections are occurring as well, and for how long the incontinence has been occurring. We will also ask about bowel movement frequency, consistency and any incontinence of stool. The more information or detail the parents (and the child in older children) can give us, the more quickly we can pinpoint the cause of the incontinence and provide the correct recommendations, treatments and sometimes medications to achieve continence. If your child is seeing us for incontinence, please be prepared to answer these questions with as much detail as possible.
Continence problems can be some of the most frustrating for both parents and children. As physicians who only treat children, we understand these frustrations and provide compassionate assessments, treatment recommendations and ongoing follow-up to help your child achieve continence.