Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Medications should be reserved for select children.
Less than 1% of all affected children have persistent incontinence into adulthood.
What is urinary incontinence?
Very simply stated, urinary incontinence is
defined as the loss of complete control of the act of urination or the
involuntary emptying of the bladder. It is also referred to as enuresis. It can
be caused by any number of factors, and in young
toddlers, it is
usually completely normal. In order to understand the different causes better,
one must have some basic understanding of processes involved in urination
How does the urinary system work?
The urinary system is made up of the
kidneys, ureters, bladder, and urethra. Urine is produced by the kidneys and
drains via the ureters to the bladder. The bladder serves as the storage tank,
stowing the urine until emptied through micturition (urinating). The act of
emptying the bladder requires significant coordination between the brain, nerves,
and muscles. There are two major muscles involved in urination, the detrusor and
the sphincter. The detrusor is a large muscle which contracts to squeeze urine
out of the bladder, and the sphincter is a group of muscles which remains
contracted to keep urine in the bladder. These two muscles must work in concert,
one contracting while the other relaxes, to control the flow of urine.
Dysfunction in either may result in some degree of loss of urinary control. The
urethra serves as the canal which carries the urine from the bladder during
voiding. Achieving bladder control must be learned, and some children learn
earlier than others, and therefore urinary incontinence is normal in most young
infants and children, but in older children and
adolescents, it is not
If your child is younger than 5, don't worry about
bedwetting. Many children do not stay dry at night
until age 7. Most children outgrow wetting the
bed. A single episode of bedwetting should not
cause alarm, even in an older child.
If your child is 7 years old or older and wets the
bed more than two or three times in a week, a
doctor may be able to help. If both day and night
wetting occur after age 5, your child should see a
doctor before age 7.
SOURCE: National Kidney and Urologic Diseases Information Clearinghouse
While the patient's history and physical examination are the building blocks of making a medical diagnosis, the ability to peer inside the body can be a powerful tool. Ultrasound is an imaging technique that provides that a"...