Questions posted in the The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.

Question Title: still wet during day

Forum: The Urology Forum
Topic: Pediatric Urology

my 6 year old has never been dry during the the day .(he also wets at night)He will often wet is pants several times in a day.when questioned he says that he didnt get any feeling to go. Most the time he knows he has to go because he gets a drop out of his penis he will then cross his legs or hold his penis and runs to the toilet.
we have had two ultrasounds done the first showed two peripelvic cysts with post voiding volume of 40 mls. A second ultrasound (6 monthes later)showed a post voiding volume of 21mls(the dr thinks this good result was just a fluke). The first cyst was still there and was located in the sinus. There was a second filled fluid mass thats shape indacated renal pelvis or could be a cyst mouled to the sinus this report said the cysts were parapelvic.The report also said the only way to see if the second fluid collection was cyst or pelvis was by ivp. would having a ivp and its result effect treatment or would it be purley academic(i thoutht you just left cysts alone they caused no problems).My son also had a spine xray done that showed increased interpedicular distances of the L3-L5 levels(3.5 at L5) with slight flatting of tne internal aspects of the pedicles.
We have tried ditropan for wetting but it did not do any good.
The dr has not been helful with information and seems to just want to wait. Though he did say the films showed a few abnormal results. at one time there was talk about a mri but now he wants to wait .He seems more concerned with the cysts and dosn"t seem to want to adress the wetting. what would you suggest has the next course of action and what could cause his problems .
at this stage i dont know if I should seek a second opinon or just ignore the problem. thanks for your time

Dear Mum,
Nocturnal enuresis (nighttime wetting ) is a common problem that affects many families. The incidence of nighttime wetting decreases with age. At age 5 yrs old, 10% of children are wet. By age 10, the incidence decreases to 5 %. By the time children reach adolescence 1 % still have this problem. Most children therefore will grow out of it.
In your son’s case there is a component of daytime wetting as well. Males with day and night time incontinence should be evaluated for a condition called posterior urethral valves. This condition arises in utero. The urethra develops abnormally with resultant bladder abnormalities that can cause enuresis. The test to diagnose posterior urethral valves is called a Voiding CystoUrethroGram (VCUG). Dye is instilled into the bladder using a catheter. The catheter is then removed and the patient is allowed to urinate on his own while xray pictures are taken. Posterior urethral valves has a characteristic appearance.
Another possibility is a neurologic problem such as spina bifida occulta. This is a very mild form of spina bifida in which the person can walk and has some control although incomplete of the bowels and bladder. This is best seen on an MRI which it sounds like your doctor has already discussed with you.
If no abnormality is found, then most likely your son will grow out of this condition. I must mention to you that psychological conditions can manifest as incontinence. Stress in your son’s life such as divorce, new child, new school or recent move can cause this condition. Although in your case this is unlikely since he has had this problem since birth.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).

HFHS M.D.-KR
*keyword: bedwetting, enuresis
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