How To Prepare for a Continence Appointment

Before your appointment:

  • You will be sent a confirmation email as soon as you book an appointment. Please complete the patient intake form with all relevant information as soon as possible.

  • We will email a bowel diary for you to complete prior to your child's appointment. Please read the instructions carefully and complete for 1 week prior to your appointment (as able).

  • If you are seeing Sarah for a bladder-related concern (e.g. bedwetting or day wetting), please also complete the 2-day bladder diary provided to the best of your ability.

  • The more information we can gather prior to your child's appointment, the better!

Preparing for your child's appointment:

  • It’s helpful for your child to come to their appointment with a reasonably full bladder, so that we can perform some assessments (e.g. ultrasound and uroflowmetry) if necessary.

  • We recommend that your child voids/wee’s one hour before the appointment and then drinks approximately 500mls gradually over the hour leading up to the appointment.

  • If your child does have to void/wee immediately prior to the appointment and cannot hold on (we understand, this happens!), try to drink a cup (250ml) immediately after and let your Physio know when you start the appointment. 

Ultrasound for constipation (rectal diameter measrements), bladder volume measurements and pelvic floor assessment

Assessment Tools

The following tools can be used during your child’s appointment to gather valuable information about their bladder, bowel and pelvic floor function.

If your child has difficulties with new experiences, it can be useful to show them some videos beforehand or practice some of the elements of the assessment to make them feel less daunting. If your child has any preferences you would like us to know about, please let us know prior to their appointment.

Sarah Henderson Physiotherapist performing realtime ultrasound on a child during an assessment (Geelong)

Tips for preparing for ultrasound:

·       Practice the procedure by using some gel or moisturiser and household item similar to a transducer (e.g. deodorant bottle or back of a spoon)

·       Break down the task using social stories

·       Practice breathing or distraction techniques such as counting or playing with a favourite toy

·       See the video below from the Royal Children’s Hospital for a “Child’s Guide to Ultrasound”

https://www.rch.org.au/be-positive/A_childs_guide_to_hospital/Ultrasound/

Uroflow Geelong used to assess bladder and voiding function

Uroflowmetry

Uroflowmetry is also a non-invasive diagnostic test used to measure the flow rate of urine during urination. It helps assess how well the bladder and urethra are functioning, providing valuable insights to guide our diagnosis and management.

During a uroflowmetry test, your child will be asked to sit on a special toilet seat and urinate into a jug with the uroflow device attached underneath. This will record the rate and volume of urine flow and transfer this data to a computer to analyse.

Uroflowmetry can detect abnormalities in urinary function, such as irregular flow, which may be contributing to your child’s continence or toileting concerns. It is also commonly used to monitor urinary function following procedures (e.g surgery or botox) or medications.

Realtime Ultrasound

A transabdominal ultrasound is a non-invasive imaging procedure used to assess the bladder, rectum/bowel and pelvic floor muscle function. This test is simple, quick and painless, using high-frequency sound waves to create detailed images of the pelvic structures.

During the procedure, a small amount of cool gel is applied to the lower abdomen, and a handheld device called a transducer is moved over the skin to capture real-time images. This ultrasound is commonly used to evaluate bladder volumes (pre and post void), rectal measurements to demonstrate constipation and impaction, as well as pelvic floor muscle function.

This is an essential tool to help guide both diagnosis and treatment pathways, providing an opportunity for clear outcomes measures and ongoing monitoring.