Page 1 - Dysfunctional Elimination in Children
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Urological Health

                                Dysfunctional elimination

                                in children

        Dysfunctional elimination of urine and stool in children may be corrected with the
        encouragement and support of parents under the guidance of your doctor.

             ody waste products are flushed out in the urine      Dysfunctional elimination
        Band stool. Urine is produced in the kidneys
        and then carried through long narrow tubes, the           Children with abnormal voiding (urine elimination)
        ureters, into the bladder. It is stored in the bladder    or defecation (bowel elimination) habits are felt
        until emptied through its outlet, the urethra. During     to have a dysfunctional elimination syndrome. The
        emptying, the outlet control muscle (urethral             cause of this condition is unknown. These children
        sphincter) should relax completely while the bladder      may be prone to urinary accidents during the day
        contracts to expel urine. Solid waste and unabsorbed      (diurnal enuresis) or night (nocturnal enuresis), bowel
        food is eliminated in the stool.                          accidents (encopresis) or urinary tract infections.

                                                                  Some children will have an overactive bladder with
                   Female urinary tract, side view                intense urges to void, frequent urination and wetting
                                                                  associated with these urges. You may notice your
                                                                  child dancing or squatting in an effort to suppress
                                                                  urges to void and prevent wetting.

                                                                  Others resist the signal to void and may do so only
                                                                  two or three times daily. These children may develop
                                                                  an overstretched bladder which cannot contract
                                                                  and empty effectively. This may result in wetting or
                                                                  infection. This is also described as a “lazy bladder”.
                                                                  In some cases, a child may not be able to relax the
                    Male urinary tract, side view                 urethral sphincter completely when trying to void. The
                                                                  partially closed sphincter causes resistance to bladder
                                                                  emptying which causes, high bladder pressure. The
                                                                  incompletely emptied bladder often leads to wetting
                                                                  or infection. Rarely, high bladder pressure may lead to
                                                                  kidney damage.

                                                                  Some children may have elements of several voiding
                                                                  dysfunctions at once.

                                                                  Bowel function may also be a problem in children.
        In infants, the bowels and bladder empty by               Constipation may be present if bowel movements
        reflex. When full, the bladder or bowel empties           occur less than every other day or the stool is large or
        automatically. Normally, a child gains control of         very hard. Bowel accidents is usually a sign of severe
        bladder and bowel function by three years of age.         constipation.
        A child’s bladder normally fills and empties four to six
        times daily. Bowel movements usually occur every day
        or two.

        Daytime control of urine usually occurs by the age
        of three with nighttime control occurring a bit later.
        Some children have persistent bedwetting for several
        more years, but most will be dry by the age of seven.                                Continued on next page
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