What to expect at a pediatric pelvic physical therapy appointment

So, your child has bladder and bowel issues and you’ve decided to take them to a pediatric pelvic physical therapy therapist. Your next question may be: what can I expect when I take my child to the doctor or pediatric pelvic physical therapist for his/her first visit?

Before going into depth about bladder and bowel conditions such as incontinence, urgency, and bedwetting, we thought it would be helpful to give information about how you can prepare for the first visit and get the most out of the time with your provider.

What to bring to a pediatric pelvic physical therapy appointment

First of all, if you are going to this particular health care provider for the first time, gather your child’s health record and complete history. These records can be easily sent from your child’s previous doctor’s office before the first visit. If possible, it is even better to get the health records in your own hands and make the necessary copies.

Also, it will be very helpful to take the time to notice your child’s habits and symptoms and record his/her patterns of voiding, diet, length of time in the bathroom, fluid intake, symptoms, your child’s complaints etc.

Bringing all of this information with you to your appointment will be a huge help for your provider.

What to expect in the physical therapy office

When you sit down with your provider you and your child will be asked several questions about the history of the problems and other health issues. Letting your child answer as many questions as possible will begin your child’s process of him/her taking control and responsibility for their own bladder and bowel health.

Questions can include:

  • How was the pregnancy, childbirth, developmental milestones of your child?
  • How long have they had the symptoms?
  • If bedwetting, how often does it happen and if repeatedly happens at certain time of night. (if you have tried bed alarms you might know this)
  • Does your child lose urine continuously or is it intermittent?
  • How much urine or feces does your child lose?
  • What are your child’s toileting habits: How often do they go? Do they strain to empty? Is the flow constant, or does it stop and start? Do they complain of pain?
  • How frequent are your child’s bowel movements? Do they have to strain to empty?
  • What is your child’s diet like? They will be especially interested in intake of water, fruits vegetables and fiber.
  • Is your child a heavy sleeper?

After receiving your child’s complete history, you could expect the following:

Examination: The provider should do a physical examination including visual inspection of your child’s perineum while you are in the room. Internal examination should only be done with your consent and for a clear reason (e.g. rectal exam in the case of chronic constipation).

Healthy bladder habits for children
A pediatric physical therapy specialist can be a trusted partner in your child’s healthcare.

Urinalysis: They will most likely ask for a urine sample to rule out urinary tract infection or other kidney or pancreatic conditions.

Bladder/Bowel Diary: Your provider probably will send you home with a bladder and/or bowel diary to track your child’s toileting habits, fluid intake and diet for at least 2-3 days. This is a more detailed accounting of symptoms and habits.

Other Tests: Other tests may be ordered such as an abdominal ultrasound to look at the bladder before and after emptying, or a uroflow test that assesses (as the name implies) the flow of urine and can detect dysfunctional voiding patterns in your child. More invasive tests are usually not warranted until other more common issues are ruled out. Then your pediatrician may refer you to a pediatric urologist or gastroenterologist who has more specialized experience in these issues.

Please remember that the above information is a guideline to help you when you take your child to your healthcare provider. If you have questions please contact us here at Pelvic Wellness Center.