At UT Urology in Chattanooga, we offer a comprehensive menu of services, including pediatric urology tests and treatments. Children of all ages can develop various urologic problems. Most who do have a difficult time communicating their experience. This is why it is important that parents and caretakers know the conditions that may occur and what to do about them. Here, we discuss some of the conditions for which a child should be brought to a urologist. 

Urinary Tract Infection

We do not usually think of urinary tract infections as a problem that would affect a child. However, bacteria are present in all people of all ages, so it is not unheard of for a youngster to develop urinary symptoms. Urinary tract infections are more common in girls but may also develop in some boys. The origin of this infection are germs or bacteria that remain in the urethra after urination. A child with a UTI may feel generally unwell or may complain of burning when they urinate. The urine of a child with a UTI may be cloudy, foul-smelling, or blood-tinged. A course of antibiotics should resolve these symptoms.

Bedwetting

Children wet the bed from time to time; it’s a normal thing that happens for a number of reasons, including simply being very deep in sleep. As a child gains bladder control after potty training, bedwetting usually becomes very infrequent until it does not occur at all. If a child is consistently wetting the bed at age 5 or 6, a urologist may perform a consultation and examination to see if the child is incontinent or has an underlying condition, such as chronic UTIs, that is causing the frequent nighttime urination. 

Undescended Testicles

It is not uncommon for a newborn boy to have undescended testicles. Statistically, this happens in about 4 out of every 100 newborns. Approximately 21 preemie boys out of 100 are born with this condition. Having an undescended testicle means that one or both of the testicles have failed to drop into the scrotum. Instead, they remain in the abdominal wall. A urologist may recommend observing the condition until the baby is a few months old to see if the testicles descend naturally. If they do not, they pose a health risk. A minimally invasive procedure can be performed to manipulate the testicles into place and secure them with a stitch. 

The signs and symptoms of urologic problems in children may be difficult to discern but should not go unnoticed. We have discussed just a few of the conditions that warrant a visit to a pediatric urologist. If you have questions about a child’s symptoms or suspect a urologic problem, contact our Chattanooga urology practice at (423) 778-5910 and schedule a visit to our Pediatric Urology Clinic. 

Many adults, especially women, have had at least one urinary tract infection or know someone who has. This infection occurs from an overgrowth of bacteria in urine. Because the urethra, the tube through which urine passes, is shorter in women, we see more cases affecting them than men. In most cases, a UTI affects the bladder. There is a chance that the infection could affect the kidneys. Proper treatment is necessary as quickly as possible to prevent kidney infection and restore comfort. Here, we discuss what parents should know about UTIs and how to spot signs of this infection in a youngster. 

Symptoms of a UTI

A UTI can develop anywhere within the urinary tract. When the infection enters the bladder, it is called cystitis. Symptoms include:

• A sensation of urinary urgency
• Frequent urination
• Difficult or painful urination
• Incontinence during the day or bed-wetting
• Foul-smelling urine
• Blood in the urine

If infection affects the kidneys (pyelonephritis), a child may develop a fever and chills, fatigue, back or side pain, or nausea and vomiting. Any signs of urinary tract infection warrant a prompt visit to the pediatrician for a full consultation and examination. 

Treating a UTI

No treatment should begin until a doctor has examined the child and run a urine test. Children who are potty trained can usually do a standard urine specimen in a sterile container. A catheter, a thin tube, may be inserted through the urethra to collect a urine specimen from non-potty-trained children. In some cases, a urologist may order imaging of the bladder or kidneys to observe structural anatomy for potential abnormalities that may be involved. In most cases, it is not anatomy that causes a UTI but bathroom habits, which can be irregular in children.

Treatment for a UTI is determined by the diagnosis, which identifies the type of bacteria in the urinary tract. A doctor prescribes antibiotics to eradicate the infection. It is imperative that parents avoid giving a child antibiotics without proper testing. The right antibiotic is needed to properly treat each case. 

Are Pediatric UTIs Preventable?

Barring any anatomical abnormalities, it is possible to reduce the risk of subsequent UTIs with a few simple steps. One is to train a child to use the bathroom frequently. Holding urine too long may allow bacteria to accumulate. Children who struggle with constipation may benefit from a fiber supplement or foods that are high in fiber, remembering that it is imperative to drink plenty of water when taking fiber. 

If your child experiences recurring urinary tract infections, they may benefit from a consultation with a board-certified urologist. To schedule a visit at one of our Chattanooga offices, contact us today.

The uncontrolled urination that occurs while a person sleeps is called nocturnal enuresis. In childhood, it is usually referred to as bedwetting. Usually, by the age of 4, a child can control their bladder. It is estimated that about 10% of children aged 6 to 7 still do not have this ability. They have accidents during the day, at night, or both. If this happens, it’s worth a consultation with a pediatric urologist.

What You Should Know about Bedwetting

There are primary and secondary forms of nocturnal enuresis. Primary nocturnal enuresis is when a child has never achieved full bladder control since potty training. Secondary nocturnal enuresis is when a child had been dry for at least six months but has begun having nighttime accidents. Fortunately, both types of enuresis are treated similarly.

It is important for parents to understand that, if their child wets the bed, it is not because they are lazy or willful. It rarely has to do with general behavior. There are usually other factors at play. These include:

• Genetic influence. If a child’s parents both experienced enuresis as children, their risk for this problem is 75%. Scientists have dubbed this as having a “bedwetting gene.”
• Deep sleep. Children who wet the bed often sleep very deeply. This can affect the communication between the bladder and the brain. When the bladder is full, the pelvic floor muscles relax and the bladder empties instead of the bladder signaling the brain to wake up.
• Low bladder capacity. Some children have small bladders that cannot hold much fluid, resulting in enuresis.
• Too much urine production. Some children’s kidneys work hard at night, making more urine than the bladder can hold. This relates to the natural production of a hormone called antidiuretic hormone, which usually increases at night. Another reason for increased urine production at night is drinking caffeinated beverages.
• Type 1 diabetes. This condition is caused by a lack of insulin. This hormone regulates the body’s use of sugars. Without it, sugar is lost in the urine and may increase urine production. Bedwetting may be an early indicator of this illness.
• Sleep disorders. A child who sleepwalks or has obstructive sleep apnea may be more likely to wet the bed. Obstructive sleep apnea deprives the brain of oxygen for up to several seconds, which can result in the production of atrial natriuretic peptide, a chemical that causes extra urine production at night.
• The rectum is located adjacent to the bladder. If the stool is stored in the rectum due to constipation, the bladder may be compressed and less capable of holding urine.
• Emotional or physical stress is a relatively common cause of bedwetting. Wetting the bed can exacerbate stress, creating a vicious cycle for the child.

There are several ways to approach childhood bedwetting. All include a heavy dose of compassion. If your child wets the bed, talk with their pediatrician, or schedule a consultation with us. We can help. Call UT Urology at (423) 778-5910 to schedule an exam for your child.

Bedwetting may be a relatively normal behavior for young children. However, there comes a point when a parent may wonder if they should talk to a doctor about this problem. Here, we discuss some of the details of childhood bedwetting to help you determine if your child may need medical intervention.

Is bedwetting ever normal for a child?

It may be quite normal for a child to be unable to stay dry for an entire night during the period in which they are actively potty-training. A child may be potty trained sometime between the ages of 2 and 4. When a child of this age wets the bed, it is considered a mere physical symptom that indicates their nervous system is not yet at a stage in which the urge to urinate wakes them.

It has been estimated that approximately 40% of 3-year-olds exhibit primary bedwetting. By age 5 or 6, the nervous system should be mature enough to wake the child when the urge to urinate occurs during the night. At this age, approximately 85% of children are able to stay dry throughout the night.

Bedwetting frequency: what is considered abnormal?

A child may wet the bed as often as every night while they are potty-training. We expect this to decrease as the nervous system matures. If a child reaches age 7 and is still wetting the bed several nights a week, a specialist should be consulted. A consultation with a pediatric urologist can help determine why bedwetting is persisting.

What are the treatment options for bedwetting?

Primary bedwetting that may relate to the nervous system development may be treated with lifestyle modifications and home remedies.

The first strategy parents may use is to limit the fluids a child consumes after 3 pm. By monitoring how much a child drinks in the late afternoon and evening, parents may be able to limit how much urine is stored during the night. Also, the child should use the bathroom right before going to bed. When a child makes it through the night without wetting the bed, they may receive a reward such as stickers or small prizes. Nightlights can also be placed along the path from a child’s room to the bathroom to help them feel comfortable getting to the toilet in the event they do wake up.

Secondary bedwetting is not related to potty-training or an underdeveloped nervous system. This term describes frequent bedwetting that relates to another condition. For example, children with Type 1 diabetes may produce more urine due to elevated levels of blood sugar. A urinary tract infection may also be a cause for bedwetting. Emotional triggers such as school stress may also be a cause for bedwetting in a child who had previously been able to stay dry all night.

Children aged 6 and older should be examined if they experience persistent bedwetting despite the implementation of home strategies. If you would like to schedule an appointment in our Chattanooga urology office to discuss why your child may be wetting the bed, call (423) 778-5910.