4.08.2013

Frequent peeing update: Testing for UTI, constipation, overactive bladder, spasms, growth spurt...

So it's been more than a week since I first took my 4 year old daughter into the doctor because of her frequent urination and finally we have some answers...although I'm left with more questions. 

Just to recap quickly (you can read my original post on the frequent peeing problem here) - she was getting up several times at night to pee and on her two worst days peed between 40 and 50 times a day.  Through a urine test, doctors ruled out a UTI (she also has no pain) and diabetes insipidus.  After the second urine test came back, our pediatrician recommended we wait a week and monitor her pooping pattern because she explained frequent peeing can actual be a sign of constipation.

After two and half days (sorry, this mama can't wait a full week...so I rounded up) of writing down everything that came out of her and at exactly what time, I figured two or three normal looking poops a day meant she wasn't constipation.


We are lucky to live near one of the best pediatric hospitals in the country so I called the urology department thinking it would be at least a week to get in.  They were able to get us in the next day.
Armed with four pages of notes about exactly when she ran to the potty over 3 days (one day it was 23 trips between 5:30pm and when she was finally able to fall asleep) we were off to meet the pediatric urologist at AI Dupont/Nemours Children's Hospital.

Again...and again...and again...
We were barely checked in before my daughter needed the restroom.  By the time she got done in there, they took us to our exam room where she informed me she had to go again. I peeked my head out the door to ask where the bathroom was and one of the doctors asked why she was in (thinking she may need a urine test) when I said "frequent urination" she kind of chuckled and sent us into this special room.  It had a special toilet that spins and measures the flow of pee and all this cool stuff...my daughter dubbed it  "interesting" before asking me to leave so she could poop.  Somehow thinking this thing wasn't equipped to handle #2 I ran down and asked the nurse and doctors who pulled her off the potty so fast she didn't know what hit her.  We were later told the spinning parts would make a real mess of the wall if anything but pee went into the potty.  Whew...close call.


Finally, we met with the nurse who drilled me on her peeing patterns, behaviors (was she doing this for attention? because I'm potty training my son?), how much she's emptying, bed wetting (which she's not), accidents (again, no), and so on.  From there it was determined she needed an X ray and a ultrasound to determine if there were any problems with her kidneys, bladder, stomach or as the doctor put it: "if she's full of poop because constant peeing can be a sign of constipation."  They kept coming back to this, but I was sure it was not the case.

All the tests came back normal...she did not have any weird tumor, an extraordinary amount of poop,  or a kidney dysfunction.   The urologist also ruled out that the frequent peeing is behavioral since she's getting up in the middle of the night and getting frustrated by the fact that she has to keep going.

They also ruled out Pollakiuria aka Extraordinary Daytime Urinary Frequency Syndrome. This was ruled out because kids with this condition don't wake up at night to pee.   It did seem like this was the closest match because she has no other symptoms and only very small amounts of urine are produced...both symptoms of this rare diagnosed condition that does not require treatment and goes away on its own in several weeks to months.

Since we already knew it was not a UTI or inspidus those were also off the table.  That left us with two other possibilities: Overactive Bladder and bladder spasms.   A bladder scan showed that even at the tiniest amount of urine in the bladder, Olivia would feel as if she has to go to the bathroom. 

While she has no other symptoms and she's not in any pain, the doctor felt it best to treat this as bladder spasms because of how disruptive it has become.  The medication is supposed to relax her bladder so it stops spasming and therefore she does not feel as if she has to pee at every drop of pee.

We are now on day three of medications and while we're seeing a decrease in daytime peeing, she's still getting up several times at night to pee.  

And so we continue to wait to see if the medication helps and how she will react to it...as with many meds the list of side effects is longer and more extreme than her current symptoms.

My questions big questions now about my four year old girl's frequent peeing are:

How long will she need to be on medication? 
What if the medication doesn't work? 
What caused this sudden onset of frequent urination? 
Is it possible the frequent peeing is related to a growth spurt? 
Will this be a problem long-term or will she grow out of it?

3 comments:

Anonymous said...

hi! i am mini from india mother to a 4 yr old girl who has exactly the same symptoms as your daughter. we have already consulted a pediatric nephrologist and she is under antibiotics for the past 2 weeks. trisha's frequent urination problem started in feb 2013 and is slightly better now. she is scheduled to have an ultrasound and another round of urine test today. she still urinates every 15 mins or sometimes 10 mins. there has been no fever or pain yet.the first urine report indicated negetive for infection however it indicated she must have had an infection wjich got drained out by water. its been 3 mnths now and i have a feeling the ultrasound and urine test will be normal. so i have the same questions such as how long this peoblem will last and what can help prevent it in future.
mini

Anonymous said...

Hey :) came across your blog when I googled about my sons same exact problem. It all started this morning for us, I'd say he's gone over 35 times since he woke :(
Did you ever figure out what the problem was? Did the meds help her? I'm at my wits end it's only been one day, I'm hoping he sleeps.

Melissa Viscount said...

Hi...So my daughter is now almost 5.5 and she is currently on Detrol for the frequent urination. We went through a lot o testing when it continued like this for weeks. A pediatric urologist did xrays, ultrasound, urine tests, and bladder scan. I was questioned a lot about whether she might be constipated which seems to be a big contributor to frequent peeing. She was not. I was also asked a lot about if this could be an attention seeking behavior. That was ruled out since my daughter was getting up at night to pee and was very upset about how disruptive it was. She would frequently question me about where we were going and if they would have a bathroom - she hated it. UTI was also ruled out (that was the first test). The docs determined she was having bladder spasms (on set by stress they thought - what stress does a 5 yo have???) by the bladder scan. It showed any tiny amount of pee would make her feel like she had to go. The first bout of meds she was on twice a day and it seemed to work so we weaned her off. But right before she started kindergarten she went through a relapse and started up with peeing 50+ times a day. I can't know for sure, but a counselor at her summer camp apparently made her 'hold it' which is a big contributor to spasms for someone who has a sensitive bladder. Anyway, it took about 2 weeks, but she got back under control and she is not on Detrol 1x a day. All of her teachers know she is NOT to be told to hold it as they can send her into a relapse again which spirals downhill quickly and is hard to get out of. I hope that helps...good luck :)

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