Children’s Pelvic Physiotherapy
What is Paediatric Pelvic Physiotherapy?
Becoming toilet-trained usually happens naturally. Most children achieve this between the ages of two and four. However, to become toilet-trained, children need the ability, willingness, and understanding. They must be able to feel when they need to urinate or defecate and understand the purpose of a potty or toilet.
Typically, children first become toilet-trained for bowel movements and then for urination. Sometimes, this process doesn't go smoothly, and children may continue to have "accidents." Additionally, abdominal surgery, congenital anomalies, or traumatic experiences can cause issues with urination and defecation.
The pelvic floor muscles play a crucial role in urination and defecation. Normally, these muscles are relaxed. They contract to hold in urine and stool and then fully relax to allow urination or defecation. In children with urinary or bowel problems, these muscles often work too hard, and the child needs to learn how to relax them.
A paediatric pelvic physiotherapist is trained to teach children, in a playful manner, to feel where their pelvic floor muscles are and to help them gain control over these muscles.
Common Complaints
- Urinary and fecal incontinence
- Frequent urination
- Recurring urinary tract infections
- Bedwetting
- Holding in urine for too long
- Difficulty reaching the toilet in time
- Constipation
- Abdominal pain
Assessment
During the first visit with your child, an introductory conversation takes place. The paediatric pelvic physiotherapist will identify the concerns of both you and your child. Questions will be asked about eating, drinking, bowel movements, urination, and physical activity.
You'll be instructed on how to fill out bladder and bowel diaries with your child. A physical examination will assess your child's overall motor skills.
At the second appointment, the physiotherapist will examine the pelvic floor muscles, which are vital for urination and defecation. These muscles need to contract to hold in urine and stool and relax to allow elimination.
After the assessment, a decision will be made in consultation with you and your child about starting paediatric pelvic physiotherapy. If necessary, coordination with your general practitioner, paediatrician, urologist, and/or continence nurse will occur. There is also collaboration within our practice between paediatric physiotherapists and pelvic physiotherapists.
The treatment will include
- Explanation of the origin and maintenance of the complaint
- Education about urination, defecation, pelvic floor muscles, etc.
- General advice on diet and hydration
- Instruction and training on toilet posture and behaviour
- Awareness of pelvic floor muscles
- Exercises to learn how to contract and relax pelvic floor muscles
- Breathing exercises
- Learning proper urination and defecation techniques
Reimbursement
Paediatric pelvic physiotherapy is covered 18 times under the basic health insurance. For children, there is never a deductible. You can access paediatric pelvic physiotherapy with or without a referral.