Kids (children and adolescence) Pelvic Health

  • Prolonged daytime wetting after being dry (ie. your child has been toilet trained) or into the age of 3 to 4 and never having been dry, is an issue that can affects kids.

    Sometimes it can be from an event which is stressful/ traumatic that causes a regression in bladder continence. Other reasons can be starting school, a new sibling, change in living arrangements, grumpy/ irritated bowels and sometimes even poor learned bladder habits.

  • Night time wetting is when a child is incontinent of urine whilst asleep past the age of 5, regularly. Sometimes there is also daytime wetting as well.

    Thorough assessment of daytime, routines, as well as clearing anything sinister.

    Management such as fluid intake education, encouraging good bladder habits, and also looking at alarm mats/ underwear can be part of treatment.

  • In children/ adolescence common types of urinary incontinence are urge related incontinence (leaking with an urge to go), stress urinary incontinence (leaking with increases in intraabdominal pressure such as running, jumping, lifting) and giggle incontinence (leaking when laughing).

    These types of urinary incontinence are more common in girls than boys. The cause is normally a complex interplay of local bladder sensitivity, muscle changes and psychological factors.

  • Is common in children, especially girls. It’s really common to see in toddlers aged between 2 and 4. When left unmanaged, it can lead to overflow incontinence (usually liquid fecal matter/ appears like diarrhoea) and/ or impaction of the bowel. It also can lead to lifelong issues with constipation/ toileting issues.

    Physio helps by creating bowel routines, assisting with advice around medications, educating the whole family around diet and lifestyle changes that are favourable for digestive health, and avoiding long term impact of chronic constipation.

  • Periods which are extremely painful, heavy and result in your teenager requiring days off school, lots of pain relief and making them feel faint/ vomit from the pain are not normal and should be investigated and managed as soon as possible. Management is usually by a multidiscplinary team of health professionals including GP’s, physiotherapists, gynaecologists, psychologist etc.

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What to expect

Careful questioning

An initial consult is usually completed with the child and their primary care giver/s.

We will ask questions around toilet training of bladder and bowels, current function of bladder and bowels and any other concerns in relation to toileting there may be.

Questioning tends to be directed towards the child as well as the care giver, with plenty of opportunity to form rapport and make the child feel safe and comfortable.

We also want to know about your child- what their likes and dislikes are, what sports they play, what hobbies they have, how they’re going at school. The more we find out the more we can tailor assessment and management, make it fun and interesting and have success.

Physical assessment

We will likely look at your child’s posture, overall muscle tone and the way they move.

We might want to gently touch your child’s tummy to feel for any firmness and assess for pain. We always ask for consent from the child before any sort of hands-on assessment.

We can use real-time ultrasound to look at the bladder and other structures in the abdomen/ pelvic cavity. This is completed through the lower tummy and is not dangerous or painful. It’s also non-invasive and no clothing is needed to be removed, normally we just ask the child to lift their shirt up.

Education and management plan

Management plans will always be agreed upon between the family and the therapist. We understand how busy lives are and we endeavour to make sure any suggestions we make for therapy/ changes at home are achievable and that everyone in the family is on board.

We will review regularly and make changes where necessary. Sometimes, it may just be a very busy period in a families life and in this case we can always put treatment on hold and come back at another time.

We work closely with other health care providers (with consent) if required, and also with teachers at school if required.