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The Bladder Function Improvement Training (BFIT) Program offers a comprehensive approach to managing dysfunctional bladder emptying (urinating, also called voiding) and includes expertise in the treatment of daytime and nighttime wetting, among other conditions.
We at Lurie Children’s know problems with urinating can be emotionally straining for children and their families. The good news is that issues associated with lower urinary tract disease (LUTD), the condition that leads to most problems with urination, is highly treatable in many children – often without using surgery or medication.
The Lurie Children’s BFIT team of experts was built specifically to treat children who are at least five years old with these issues. The experts work together with families to develop an individualized plan for each patient after their first visit and exam.
Most children with urination troubles see improvement within six months of visiting the BFIT Program, gaining confidence and skills to remain dry and participate in activities with their peers, such as overnight camps and sleepovers.
Our experienced team of specialists is available at eight locations in Chicago and its surrounding suburbs.
Though not often talked about, trouble with urinating is a common problem, and families are not alone in dealing with these issues.
About 40 percent of pediatric urology visits are related to lower urinary tract disease (LUTD), or the condition that can lead to issues like nighttime wetting, daytime wetting and other urinary problems. Furthermore, 5 to 7 million children 6 years or older have reported issues with daytime wetting. Daytime wetting occurs in 10% of 5-to 6-year-olds, and 5% of 6-to 12-year-olds.
Lurie Children’s experts in bladder function work with patients until their symptoms are completely resolved.
Many children with dysfunctional voiding show poor pelvic floor muscle relaxation caused by “holding it.” It is a learned behavior that develops over time, leading to an abnormal urine stream and poor emptying of the bladder. While dysfunctional bladder emptying happens in the voiding phase, a child will often have symptoms when not voiding, such as wetting. In most children, voiding problems can be treated without surgery.
Signs that your child has dysfunctional bladder emptying include:
Often, children with urinary issues treated in the BFIT program endure no long-term consequences after treatment.
It is uncommon, but in some cases, children can develop kidney damage. Children may also struggle with self-esteem issues, though Lurie Children’s BFIT team is trained to consider and assist in resolving these issues.
We work together with you and your child to develop an individualized treatment plan that meets your child’s specific needs. Your child will receive world-class clinical care combined with a compassionate approach to make them more comfortable during the process. We collaborate with patients and their families until a successful outcome is achieved, taking time at each visit to ensure all questions are answered.
Your first visit will include both you and your child. You will be asked to complete a three-day voiding diary (file is also available in Spanish) which provides important information about your child’s fluid intake and bathroom habits. If your child has had any testing done related to their bladder function, you should bring reports and CDs of that testing with you to your first visit. This may include copies of urine testing or ultrasound of kidneys or bladder. You can obtain the CDs from the facility that did the original testing.
Dysfunctional voiding is primarily diagnosed by reviewing a thorough patient history with emphasis on toilet habits. An ultrasound of the kidneys and bladder may be used to look for rare structural abnormalities. An abdominal x-ray may be used to evaluate for stool retention. Further evaluation may include pre-void and post-void ultrasounds to assess for residual urine. A uroflow with EMG test may be performed to evaluate the activity of your child’s pelvic floor muscles with voiding. This test may show poor pelvic floor muscle overactivity causing abnormal urine flow.
After the initial visit, follow-up visits may occur every 6-8 weeks, or more frequently, depending on the child’s needs. The number of visits needed depends on how quickly symptoms improve with management.
Treatment for dysfunctional voiding involves a multi-pronged approach individualized for each child. The components of treatment include:
The BFIT program is managed by experienced pediatric providers that are specialized in treating urologic conditions: Kavita Hodgkins, MD; Reumah Ravoori, MMS, PA-C; Hope F. McGowan, APRN-NP, PNP; and Lynn Freedman, APRN-NP.
Board-certified urologists and kidney disease specialists provide leadership for the program
If you’d like to request an appointment with one of our specialists, call 1.800.543.7362 (1.800.KIDS DOC®) or visit our Appointments page for more information.