Pediatric Pelvic Health

About 20% of doctor visits for kids are because of problems controlling their bladder or bowels. The good news is that physical therapy, which doesn't involve surgery or medicine, is really good at helping with these issues.

Symptoms

• Constipation

• Nighttime bedwetting (nocturnal enuresis)

• Daytime wetting

• Stress incontinence

• Overactive bladder

• Urinary frequency/urgency

• Urinary retention

• Frequent Urinary Tract Infections

• Vesicoureteral reflux

• Bowel incontinence and/or inability to empty bowel

• Fecal Urgency/Frequency

Constipation

Constipation is common in kids and can be related to trouble with peeing properly. It means they don't poop often or it's hard to poop, and they should be pooping at least once a day. It can be caused by different things like pain, diet, being sick, traveling, or not having good bathroom habits. Sometimes kids avoid pooping to not interrupt what they're doing. Constipation can be connected to bladder problems, and adults who are constipated often had the same issue as kids.

What is bladder voiding?

Bladder voiding dysfunction means kids might have trouble controlling their bladder because it's not fully developed. This can happen even after they're potty trained. Kids might not want to stop playing to go to the bathroom, so they hold their pee too long. This can cause problems like not being able to tell when their bladder is full, wetting themselves during the day or at night, feeling like they need to pee a lot, and getting bladder infections.

How we can help

Pelvic floor physical therapy is highly effective for treating these issues in children. Biofeedback is a central component of therapy:

• For bladder issues: Biofeedback uses stickers placed on the child’s body, connected to a monitor. This helps therapists visualize pelvic floor muscle activity and guide the child to improve control.

• For constipation: Biofeedback teaches children the proper techniques to push and relax pelvic muscles. Breathing exercises, like blowing bubbles, further help children gain muscle control.

Education is crucial. Children learn about their bladder and bowels to better understand why they experience these challenges, empowering them to manage their symptoms effectively. Therapists engage kids with interactive activities such as games, books, and visual aids to discuss bodily functions and associated behaviors.

Therapy typically begins with an initial evaluation, followed by regular 30- to 60-minute appointments. A parent or guardian is always present, and multiple sessions are often necessary for children to fully overcome their bladder or bowel control issues.