Pediatric Bladder Problems

The first thought that often comes to the minds of many people when thinking about pediatric bladder problems is bed-wetting. Though this is a very common ailment in children, it is not the only type of bladder problem that can exist in the pediatric set. Several more serious types of bladder diseases and conditions can afflict children from a very young age and can require medications and surgery to treat. If you suspect your child has a bladder problem, make an appointment with his pediatrician or get a referral to an urologist that specializes in pediatrics.

Bed-Wetting

• Most parents deal with bed-wetting and consider it a problem only when it means changing sheets in the middle of the night. Bed-wetting is widespread among preschool age children and even affects up to 10 percent of elementary-age kids, according to the Mayo Clinic. The most common cause of bed-wetting, or nocturnal enuresis, is that the child's bladder is not strong enough to get through an entire night's rest without emptying, and the child sleeps so soundly that he cannot rouse himself to use the bathroom. Mayo Clinic statistics show that nocturnal enuresis runs in families, as almost half of the children who have nighttime accidents have at least one parent who experienced bed-wetting as well. This type of pediatric bladder problem usually does not require treatment and resolves itself as the child grows older and stronger.

Urinary Tract Infection

• Children can get bladder infections just as adults do. Urinary tract infection (UTI) symptoms in children are similar to what an adult may experience, including pain and burning upon urination and producing unpleasant-smelling urine. Children who have bladder infections may also run a fever, have diarrhea and wet the bed when bed-wetting is not part of a normal routine. A UTI is a type of bladder problem that is easy to correct in most children with a course of antibiotic medication. Some kids who have recurring UTIs may have other underlying bladder or kidney conditions that will need medical attention, but this is not the norm.

Prune Belly Syndrome

• Prune belly syndrome is a type of bladder problem that affects baby boys and, according to Mount Sinai's Department of Urology, is quite rare. The only way to diagnose prune belly syndrome is through physical examination, as no outward symptoms of the condition are displayed. Babies who have this bladder disorder have a larger-than-normal bladder, reflux urine back into the kidneys and have undescended testicles. Due to abnormalities in the abdominal muscles, children who have prune belly syndrome have a stomach that appears wrinkled like a prune, hence the name of the condition. Prune belly syndrome is treated surgically to repair kidney damage and urinary reflux, give the stomach a more normal appearance and bring down the testicles. The bladder is not usually altered during surgery.

Urine Reflux and Leakage

• Vesicoureteral reflux and exstrophy are two bladder disorders found in children that prevent urine from being discharged from the urethra in a normal manner. Vesicoureteral reflux occurs when urine does not flow down out of the bladder but rather back up into the kidneys. This condition varies in severity and is measured by grades, from 1 to 5. Most children who are born with or develop reflux of this type fall into grades 1 and 2, the mildest form of the condition. Treatment of the reflux itself is not always necessary for vesicoureteral reflux grades 1 to 3, as it tends to resolve itself. Children are routinely prescribed antibiotics as a precautionary measure against UTI or kidney infections. Grades 4 and 5 may need to be surgically repaired.
  Exstrophy is a bladder condition that is diagnosed and corrected within the first few days after a baby is born. Rather than holding a spherical shape as a normal bladder does, in the case of exstrophy, the bladder lies flat. The deformed shape of the bladder causes urine to leak out into the abdominal cavity. Surgery is performed to repair the abnormalities.

Blockage

• Serious medical problems can result in blockages that prevent urine from exiting the urethra and can be fatal. One type of obstruction is called posterior urethral valves and can be spotted during routine prenatal sonograms. Tissues form in the urethra (the "valves" in the name of the condition), making it impossible for urine to pass through. Urinary reflux can result and cause kidney infection if the problem is not corrected. Babies who are diagnosed with posterior urethral valves undergo a procedure within the first week of birth to repair the blockage.