Physical exam for bed-wetting

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Physical exam for bed-wetting

When a child is being evaluated for bed-wetting, a physical exam is usually done to see whether medical conditions or sexual abuse may be causing the bed-wetting. During the physical exam, the health professional will examine the child's:

• Belly (abdomen), feeling for any abnormal lumps (masses) that may indicate a full bladder.
• Rectum, feeling for signs of constipation.
• Nervous system and spine, looking for possible nervous system defects or delays in the child's development that might be causing the accidental wetting.
• Genital area, looking for birth defects or vaginal infection. If the health professional sees continuous leaking (dribbling) of urine, he or she will do further testing for birth defects in the urinary system. The health professional will also examine the child for possible sexual abuse.

As part of the physical exam, the health professional may ask the child to hold his or her urine as long as possible and then urinate into a container. The health professional can use the sample of urine to estimate the amount of urine that the bladder can hold (bladder capacity) at one time. Normal bladder capacity (in ounces) can be estimated by adding 2 to the child's age. For example, a 6-year-old can hold about of urine at one time.

The health professional also may watch the child urinate to look for a weak urine stream, which may be a sign of a block in the urinary tract.

Credits

Last updated:	November 12, 2008
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer