Bowel Issues Affect on Urinary Issues

And then we have another question. How do bowel issues affect urinary issues and which specialist addresses which concern? Well, as we've already talked about, we have a very collaborative model here and, um, so we work together during bowel Management Week to plan, um, the care and the evaluation between all of our three services, uh, urology, colorectal, and gynecology for the girls. Um, when the, uh, Rectum is full of stool. The pelvis is a, a small area and it occupies in, in boys, the rectum and the bladder. Um, and in girls, the vagina between the rectum and the bladder. If the rectum is full of stool, it can, um, irritate the bladder. It can push the bladder out of position so that either the child can't empty when they, um, urinate or sometimes have real difficulty, um, urinating at all when constipation is very severe. So, um, the, The bowels absolutely affect the urinary tract. Um, the other thing that can happen is that with constipation, we have an increased risk of urinary tract infection. Um. And um we have a higher incidence of urinary leakage or incontinence with constipation too. So sometimes in children with, uh, especially the, um, Um, less severe malformations, the lower levels, um, treatment of the constipation through the bowel management week sometimes even resolves urinary incontinence, um, but certainly can help prevent infection, um, help achieve more functional voiding, um, to give the child's bladder the best opportunity to function as well as the potential it has. Absolutely, we would, um, strongly. Encourage that if we see that a child is significantly constipated, that that be addressed before we start undertaking any significant interventions for the urinary tract, specifically for the reasons that Debbie just outlined so eloquently. The other thing is that if your child has a lot of retained feces, there's going to be a significant bacterial burden in your child's colon, and that is going to be one of the reasons that drives your child getting recurrent urinary tract infections. So we really focus on bowel management and addressing constipation. Making sure they're having a daily fecal evacuation to empty their rectum completely, that allows the bladder to store and empty properly, it reduces the bacterial load, and just ensures appropriate urological health for their child.