Urinary Incontinence in Children

Introduction to Urinary System:

Digestive System
Vaginal laser surgery is also becoming a viable treatment option, he explained. This test involves urinating into a special container and leaving the sample to be studied. Bladder cancer is diagnosed in about 75, Americans each year and is more frequent in men and the elderly according. The bladder stores urine until the brain signals the bladder that the person is ready to empty it. Electromyogram or EMG is defined as a test that records the electrical activity of muscles.

Functional aspects

Urinary system

The nervous system consists of the brain, spinal cord, sensory organs, and all of the nerves that connect these organs with the rest of the body. Together, these organs are responsible for the control of the body and communication among its parts. The brain and spinal cord form the control center known as the central nervous system CNS , where information is evaluated and decisions made.

The majority of the nervous system is tissue made up of two classes of cells: Neurons, also known as nerve cells, communicate within the body by transmitting electrochemical signals. Neurons look quite different from other cells in the body due to the many long cellular processes that extend from their central cell body. The cell body is the roughly round part of a neuron that contains the nucleus, mitochondria, and most of the cellular organelles.

Small tree-like structures called dendrites extend from the cell body to pick up stimuli from the environment, other neurons, or sensory receptor cells. Long transmitting processes called axons extend from the cell body to send signals onward to other neurons or effector cells in the body. Each neuron in the body is surrounded by anywhere from 6 to 60 neuroglia that protect, feed, and insulate the neuron. Because neurons are extremely specialized cells that are essential to body function and almost never reproduce, neuroglia are vital to maintaining a functional nervous system.

The brain , a soft, wrinkled organ that weighs about 3 pounds, is located inside the cranial cavity, where the bones of the skull surround and protect it. The approximately billion neurons of the brain form the main control center of the body. The brain and spinal cord together form the central nervous system CNS , where information is processed and responses originate. The brain, the seat of higher mental functions such as consciousness, memory, planning, and voluntary actions, also controls lower body functions such as the maintenance of respiration, heart rate, blood pressure, and digestion.

The spinal cord is a long, thin mass of bundled neurons that carries information through the vertebral cavity of the spine beginning at the medulla oblongata of the brain on its superior end and continuing inferiorly to the lumbar region of the spine. The white matter of the spinal cord functions as the main conduit of nerve signals to the body from the brain.

The grey matter of the spinal cord integrates reflexes to stimuli. Nerves are bundles of axons in the peripheral nervous system PNS that act as information highways to carry signals between the brain and spinal cord and the rest of the body. Each axon is wrapped in a connective tissue sheath called the endoneurium. Individual axons of the nerve are bundled into groups of axons called fascicles, wrapped in a sheath of connective tissue called the perineurium.

Finally, many fascicles are wrapped together in another layer of connective tissue called the epineurium to form a whole nerve. The wrapping of nerves with connective tissue helps to protect the axons and to increase the speed of their communication within the body. The meninges are the protective coverings of the central nervous system CNS.

They consist of three layers: CSF is formed from blood plasma by special structures called choroid plexuses. In addition to nonorganic causes, there are also some less common organic causes including infection, anatomic abnormalities, neurologic abnormalities, and endocrine abnormalities such as diabetes mellitus.

What causes daytime incontinence in children? Common causes of daytime wetting include voluntary holding of urine, urinary tract infection , constipation , and wetting with giggling. Girls are more commonly affected than boys. Less common causes include more serious issues such as neurological causes neurogenic bladder , urinary tract anatomic abnormalities, and diabetes. Voluntary holding of urine is the most common cause of daytime wetting in young children.

This is often observed in 3- to 5-year-olds who don't want to take the time to use the toilet. They are just too busy to take a break and will often fidget, squirm, and hold on to their perineal areas. Most children grow out of this on their own as they get older. How do you differentiate between organic and nonorganic causes of urinary incontinence?

It is important to recognize that most cases of urinary incontinence are caused by nonorganic problems, but since there are organic causes, physicians may evaluate affected children with some basic studies.

Evaluation always begins with a complete history and physical exam. This differentiates between the otherwise healthy child and the child with underlying disease. The clinician will probably ask about psychological stressors, such as starting a new school, the birth of a sibling, or parental strife. In addition, in order to evaluate the severity of the symptoms, parents will be encouraged to keep a voiding diary.

These are diaries which document the number of daytime voids, volumes, timing, and relationship with eating and drinking. In addition, these diaries should document the frequency of daytime wetting or nighttime wetting. Besides the history, physical, and diary, a urinalysis can be helpful to screen for organic causes, such as diabetes and urinary tract infections. For children with significant daytime symptoms, ultrasound imaging of the urinary tract including bladder and kidneys may be needed to evaluate for anatomic abnormalities.

Lastly and rarely, if a neurological cause is suspected, an MRI of the spine may be indicated to evaluate for spinal cord abnormalities. What is the treatment for urinary incontinence in children? The treatment of urinary incontinence depends upon the underlying cause of the problem. The primary treatment for nocturnal enuresis most commonly involves behavioral modification.

This involves positive reinforcement, encouraging frequent daytime voiding, and periodically waking the child at night, restricting fluid intake prior to bed, and alarm therapy with devices that wake the child when the underwear or bedclothes have become wet. In all cases, most children are already embarrassed by bedwetting and it is important try to reduce the social and psychological impact of the condition.

Moisture alarm therapy has a high success rate and works best for motivated older children and parents. The basic process involves placing a probe in the undergarments or bed which alarms when it senses wetness.

Most children will sleep through the alarm; however, most stop voiding when the alarm goes off. The child's parent must get up and help the child to the bathroom to encourage voiding, change the wet sheets and pajamas, and reset the alarm. Moisture alarms generally work within two weeks to three months and should be discontinued if the child's symptoms persist after three months.

In addition to behavioral modification, there are some children who will ultimate require medication. Most commonly used medications include desmopressin acetate DDAVP , oxybutynin chloride Ditropan , hyoscyamine sulphate Levsin , and imipramine Tofranil.

All of these medications have significant potential for side effects, should be reserved for a very select population, and should be used to treat the symptoms not as a cure, while awaiting natural resolution. What is the prognosis of urinary incontinence in children? Where can people get more information on urinary incontinence in children? American Urological Association Foundation http: Male incontinence can be embarrassing, but it's treatable. Learn how to treat and manage urinary incontinence in men.

Treat and Manage the Condition. Did you or your child have urinary incontinence? Please share tips for coping or dealing with the problem.

Multiple sclerosis MS symptoms vary from person to person, and can last for days to months without periods of remission. Symptoms of MS include sexual problems and problems with the bowel, bladder, eyes, muscles, speech, swallowing, brain, and nervous system. The early symptoms and signs of multiple sclerosis usually start between age 20 and MS in children, teens, and those over age 40 is rare.

Treatment options for multiple sclerosis vary depending on the type and severity of symptoms. Medications may be prescribed to manage MS symptoms.

A urinary tract infection UTI is an infection of the bladder, kidneys, ureters, or urethra. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency.

Treatment involves a course of antibiotics. Urinary Incontinence in Children - Daytime Find a local Pediatrician in your town Urinary incontinence in children facts What is urinary incontinence? Urinary Incontinence in Children Should I take my child to the doctor? Sweat glands in the skin secrete a fluid waste called sweat or perspiration ; however, its primary functions are temperature control and pheromone release. Therefore, its role as a part of the excretory system is minimal.

Sweating also maintains the level of salt in the body. The sweat, helped by salt, evaporates and helps to keep the body cool when it is warm. In amphibians, the lungs are very simple, and they lack the necessary means to the exhale like other tetrapods can.

The moist, scale-less skin is therefore essential in helping to rid the blood of carbon dioxide , and also allows for urea to be expelled through diffusion when submerged. In small-bodied marine invertebrates, the skin is the most important excretory organ. That is particularly true for acoelomate groups like cnidarians , flatworms and nemerteans , who have no body cavities and hence no body fluid that can be drained or purified by nephrons, which is the reason acoelomate animals are thread-like nemertans , flat flatworms or only consist of a thin layer of cells around a gelatinous non-cellular interior cnidarians.

Like sweat glands, eccrine glands allow excess water to leave the body. The majority of eccrine glands are located mainly on the forehead, the bottoms of the feet, and the palms, although the glands are everywhere throughout the body.

They help the body to maintain temperature control. Eccrine glands in the skin are unique to mammals. Secretions of sweat from the eccrine glands play a large role in controlling the body temperature of humans. The two functions consist of secretion of a filtrate in response to acetylcholine and reabsorption of sodium near the duct when there is water in excess so that a sweat can be surfacing the skin.

There are three parts to the eccrine sweat gland and these are the pore, the duct, and the gland. The pore is the portion that goes through the outermost layer of the skin and is typically microns in diameter. The duct is the part of the sweat gland that connects dermis cells to the epidermis.

It is composed by two layers of cells and is between 10 and 20 microns in diameter. The gland does the actual secretion and it lies deep within the dermis. The cells that make up the gland are larger in size than the duct cells and its lumen is around 20 microns in diameter.

After bile is produced in the liver, it is stored in the gall bladder. It is then secreted within the small intestine where it helps to emulsify fats in the same manner as a soap. Bile also contains bilirubin , which is a waste product. Bile salts can be considered waste that is useful for the body given that they have a role in fat absorption from the stomach.

They are excreted from the liver and along with blood flow they help to form the shape of the liver where they are excreted. For instance, if biliary drainage is impaired than that part of the liver will end up wasting away.

Biliary obstruction is typically due to masses blocking the ducts of the system such as tumors. The consequences of this depend on the site of blockage and how long it goes on for. There is inflammation of the ducts due to the irritation from the bile acids and this can cause infections. If rupture of the duct takes place it is very traumatic and even fatal.

Within the kidney, blood first passes through the afferent artery to the capillary formation called a glomerulus and is collected in the Bowman's capsule , which filters the blood from its contents—primarily food and wastes. After the filtration process, the blood then returns to collect the food nutrients it needs, while the wastes pass into the collecting duct, to the renal pelvis, and to the ureter, and are then secreted out of the body via the urinary bladder.

When substances are not properly dissolved, they have the ability to build up, and form these kidney stones. These stones are most commonly made up of substances such as calcium, cystine, oxalate, and uric acid, as these are the substances that normally would dissolve within the urine.

When they do not dissolve correctly and further build up, they will commonly lodge themselves in the urinary tract and in this case, are usually small enough to pass through urine. In extreme situations, however, these stones may lodge themselves within the tube that connects the kidney and the bladder, called the ureter.

In this case, they become very large in size and will most likely cause great pain, bleeding, and possibly even block the flow of urine. In those extreme situations, in which kidney stones are too large to pass on their own, patients may seek removal.

Most of these treatments involving kidney stone removal are done by a urologist; a physician who specializes in the organs of the Urinary system. Larger, more serious cases may demand Cystoscopy, Ureteroscopy, or Percutaneous Nephrolithotomy, in which the doctor will use a viewing tool or camera to locate the stone, and based on the size or situation, may either chose to continue with surgical removal, or use the shock wave lithotripsy treatment.

Once the kidney stone s are successfully eliminated, the urologist will commonly suggest medication to prevent future recurrences. Pyelonephritis is a type of urinary tract infection that occurs when bacteria enters the body through the urinary tract.

It causes an inflammation of the renal parenchyma, calyces, and pelvis. In acute pyelonephritis, the patient experiences high fever, abdominal pain and pain while passing urine.

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