Wetting accidents, frequent urinary tract infections or constipation can be upsetting for you and your child. We are here for you. At the Dysfunctional Outpatient Voiding Education (DOVE) Center at Children's Hospital of Philadelphia, we will sort out what is causing these problems and develop a plan to help correct them.

The DOVE Center is one of the biggest and best clinics in the United States for kids with bladder and urinary problems. Our team includes urologists, nurse practitioners, nurses and psychologists.

At your child's first visit with us, a doctor or nurse will ask about your child's health and how often they go to the bathroom. They will also check your child's tummy, back and private parts. It's good to bring a record of your child's bathroom habits to this first visit.

After talking with you and your child, we might suggest doing some tests to make sure of the diagnosis and create a plan for treatment. The tests your child may undergo include:

• Uroflow: This is a simple and noninvasive test used to measure the flow of urine (pee). During the test, your child will pee into a special device that measures the speed and amount of urine. This test tells us how well the bladder is working, and it can help detect problems with urination, such as difficulty emptying the bladder or slow urination.
• X-ray of the belly (this test is also known as a KUB). This can help us tell if your child is constipated. Incontinence (the loss of control over pee that leads to leakage of urine) and constipation (difficulty or pain during bowel movements) often happen together. Treating constipation can lead to a big improvement in wetting.
• Ultrasound to check the size and shape of the kidneys and look for bladder issues.
• Video urodynamic study (VUDS): This is a test that helps us understand how the bladder works. During the test, pictures and videos are taken of the bladder as it fills up and empties. This helps us see if the bladder is working properly. The test is used to find out why your child might have trouble peeing, have accidents, or go to the bathroom a lot. It can also help us decide on the best treatment.

Based on the results of your child's evaluation, our DOVE Center team may then suggest a variety of treatment approaches, including:

• Changing voiding/stooling habits: We often recommend that children start stool softeners in order to treat any underlying constipation. We also work with parents to help them develop a schedule with their child that involves regular peeing and pooping throughout the day.
• Increasing fluid intake: Families sometimes limit the amount that a child drinks to manage wetting. But it's important to teach your child to drink water every day. We will talk to your child about why drinking water is important and suggest how much water they should drink each day.
• Biofeedback training: Biofeedback training can help kids learn to relax their muscles to empty their bladder completely. This can reduce urgency, wetting and urinary tract infections. It involves using special techniques to show when the muscles are tensed and how to relax them.
• Behavior modification: Our psychologists help you and your child learn about how the body works and why it's important for kids to follow our treatment advice. We are one of the few pediatric urology programs in the country with psychologists in our clinic. They play a key role in helping children who have trouble with wetting during the day and night.
• Medication: We often use medicines to treat frequent urinary tract infections in kids with overactive bladder and those who wet the bed at night.