Tight pelvic floor muscles??

[Zachsmum79]

My son is 12 and still wets the bed. He doesn't have any wetting in the daytime but seems to wee a lot during the day. He had uroflow tests done at the Evelina which showed a slow weak urine stream with some urine being left in the bladder. There was some talk about a possible bladder obstruction but on the ultrasound his bladder looked healthy (not had a kidney scan yet) but blood tests were fine. We have now been told they want to repeat the uroflow with electrode pads stuck on his pelvic floor muscles to see how they work as they suspect his issues are caused by tight pelvic floor muscles. I've never heard continece issues being caused by tight pelvic floor muscles. Tried to Google this but it was all about pelvic floor in women. Has anyone else been told this? Has anyone else had uroflow testing whilst checking pelvic floor? What can be done if his pelvic floor is too tight?

Thanks.

[Littlecabbage]

Sorry that I can't offer specific advice, but just to say that my 6 year old son has just been shown to have a slow urine flow, with more urine than usual being retained in the bladder.

We are at Birmingham Childrens Hospital currently, and they have booked him in for a cystoscopy to check for blockages. He has already had a bladder ultrasound which showed no blockages. I'll be interested to hear how you get on, good luck.

[Zachsmum79 in reply to Littlecabbage]

Thank you for taking the time to reply. It does sound like your son has an overactive bladder, although will be good to have the cystocopy and know there's no blockages. Have you googled posterior urethra valuve? This could be causing a blockage for your son and can have similar symptoms to overactive bladder.

Although my son's symptoms aren't really major, he's too embarrassed to go on sleepovers or school trips which makes me sad. When the doctors talked about a possible blockage l think he hoped there was a medical cause for the bedwetting so it could be fixed & problem solved! Obviously l dont want there to be any thing medically wrong with him, but l'm a little bit worried if they conclude it's just his tight pelvic floor muscles, l'm not really sure what can be done about that. Think the emphasise will be on him learning to relax them.

Did you have a separate kidney scan? My son had the post voiding ultrasound, which is when the Dr said his bladder looked healthy, no thickening. I asked about kidneys and she said she wasn't trained to look at kidneys, that's a separate scan. His kidney function blood test was fine though.

Hope your son gets on ok with the cystocopy, would be interested in hearing how it goes. We had to wait 2 months for the first uroflow tests so don't think we will get an appt for the repeats for a while yet but will keep you posted.

[Littlecabbage in reply to Zachsmum79]

Thanks for your reply. I have googled PUV, and while he has the symptoms of frequent urination and possibly poor urine stream, he has none of the others such as enlarged bladder, frequent UTIs , difficulty passing urine etc. But perhaps he could have the condition in a very mild form? He did have a pre and post-voiding kidney scan which showed dilation at the tops of the urethras, and fluid accumulated around his kidneys, so that could possibly fit with an obstruction. His bladder wall was also thickened.

It's weird, but none of the medical professionals we have seen since seem particularly excited about the ultrasound findings, even though they are abnormal. I have not yet seen the consultatnt urologist, but will be asking him about this specifically when we meet him on Tuesday.

I know what you mean about hoping for a medical condition but not wanting one which cannot be helped. But maybe there are solutions to tight pelvic floor muscles? Botox injections springs to mind as a possibility.

Also, if you want your appointment sooner, it may be worth ringing the admissions dept weekly for cancellations - I have managed to get one on two occasions now, and ended up being seen months and months before we were initially told we would be.

[Littlecabbage]

Forgot to mention, my son's kidney function on recent blood tests is fine.

[Zachsmum79]

I read that most puv is picked up on antenatal scans, but if it isn't, it's usually because it's a more mild case. I did wonder if this might be the case with my son initially. Hopefully the consultant will have some answers for you on Tuesday. Keep us posted!

I may well chance my luck and ask about cancellations - you never know. I know it's not urgent but it's a bit frustrating to wait ages for the uroflow only to be told they want to do practically the same test again but you have to go to the back of the queue again!

Good luck x

[Littlecabbage]

Zachsmum, I've put an update on my own post, which you may find interesting, particularly how PUV doesn't always show up on ultrasound, and also the possibility of a "functional" obstruction, where the urethral sphincter isn't always relaxing as it should be when the bladder wall muscle is contracting.

If you're at the Evelina, I'm sure you are getting very good care from what I've read from others, but might be worth asking about these things if not already discussed?

[Littlecabbage]

Hi Zachsmum,

It looks as though your son and my son may have a similar underlying medical issue. See my recent update to my own thread. I posted a link to a useful article explaining "voiding dysfunction" where certain muscles aren't relaxing at the right time when the bladder wall is contracting. I also see that biofeedback training is considered useful for this, and that the Evelina hospital does offer it. They have a leaflet all about it on their website. Hope that helps.