How to Cope with Bedwetting

Bedwetting that continues beyond the age of 5 can impact a child’s self esteem and create a sense of isolation, according to Christopher Link, post-doctoral fellow in CHOC Children’s Pediatric Psychology Department. Chris recently sat down with CHOC Radio host Bryan Mundia to talk about what parents can do to help their children cope with bedwetting.

First, it’s important to see a physician to rule out any medical causes for bedwetting occurring in older children. After medical issues have been addressed, there are some things parents can do, including limiting their child’s fluid intake before bedtime, making sure their child goes to the bathroom before getting under the covers, and avoiding caffeine.

Chris says parents need to understand that bedwetting is not a child’s fault; it’s not intentional. Instead of punishing children, parents need to reassure their children that they will grow out of it. For more helpful tips on this subject, tune into the show.

Enjoy the show!

Protect Your Kids’ Kidneys and Bladder This Summer With Lots of H20

If May’s unseasonable heat wave was any indication of the hot temperatures Orange County could face this summer, you’d better get your water bottle ready.

Children are especially vulnerable to dehydration during the summer. Kids who are active outdoors – whether they play sports or hit the beaches – need to remember that drinking plenty of water is critical to maintaining good health during the hot months.

The CHOC Children’s Urology Center treats many kids during summertime who suffer from urologic conditions related to poor water drinking, said Dr. Antoine Khoury, a pediatric urologist and the center’s medical director.

“It is remarkable how frequently children and their families forget to drink water. The fluid they take in is juice, soda and milk, and not water,” Dr. Khoury said.

A good way to tell if a child is hasn’t been drinking enough is to check the color of his urine. If it’s dark yellow, the urine is concentrated and the child needs to drink more. The urine should be pale in color or better still clear, this provides the child with immediate feedback to drink more water any time the urine is not clear. And, “Any time the child is thirsty he is already dehydrated,” Dr. Khoury said.

Drinking liquids other than water is not as effective in keeping the body hydrated, Dr. Khoury explained. Our bodies require “free water,” or water that is available to the kidneys so they can do their job filtering blood and extracting waste through urine. Giving the kidneys extra water helps them do their job.

Dehydrated children can face several serious urological problems. They include:

1) Kidney stones. Due to a lack of water intake, the urine becomes concentrated and overly rich in salts and crystals. Crystals can be a nidus for kidney stones formation. This can be a very painful condition.

2) Bladder infections. If a child’s body doesn’t make enough urine, the urine becomes concentrated. Children who don’t produce enough urine will not get the urge to urinate and tend to hold it in. Holding in urine for several hours accelerates bacteria growth and may cause a bladder infection.

3) Constipation and incontinence. The more water the colon absorbs from the food due to lack of water in the body, the harder and smaller the stool is. Children who don’t drink enough water can become constipated. The dysfunctional emptying of the bladder associated with constipation promotes incontinence and infections.

4) Urgent and frequent urination. A child’s urine can become so concentrated and loaded with crystals and salts that the bladder becomes irritated. This may lead to urgent and frequent urination.

Drinking Water Guidelines

Dr. Antoine Khoury, Medical Director of the CHOC Children’s Urology Center, recommends that children drink an 8-ounce cup of water daily for every year of age, up to the age of 8. (So a four-year-old should drink at least four cups of water daily). Kids over 8 and adults should drink 8 cups of water daily. This recommended water intake is in addition to any other fluids consumed. Finally, sports drinks are not a substitute for water!

If your child experiences a urological problem, call the CHOC Children’s Urology Center at 714-512-3919.

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One For the Books


“Your baby has no kidneys.”  That’s what Nicola and Clifford Vazquez were told when a prenatal ultrasound showed an abnormal mass where their baby’s kidneys should be. Just halfway through the pregnancy, they were also told that their baby would die shortly after birth. they were devastated.  The Vazquezes decided to get a second opinion, which ultimately led them to CHOC children’s pediatric urologist Antoine Khoury, M.D.  He saw things differently.

When Madison Vazquez was born last November, Dr. Khoury and his team were ready and waiting. Dr. Khoury used tiny, minimally invasive instruments to drain accumulated fluid that appeared to explain the abnormal  images on the ultrasound. But he sensed there was more to the picture. He decided to look further.

ar-2012-one-for-the-books2What Dr. Khoury found was a structural abnormality that was undetectable by ultrasound. It explained everything.  No one in the operating room had ever seen anything like it. But Dr. Khoury and his team used a combination of reconstructive techniques to correct the newly discovered abnormality. Their ingenuity  in the operating room saved Madison from having a more extensive surgical procedure that very same day.

“The first condition was so glaringly abnormal that it masked the primary condition,” Dr. Khoury said.  “We’ve checked the literature and haven’t found reports of anyone else using the combination of techniques that we brainstormed that day. We are submitting it for publication in hopes it may save other children from having more extensive procedures.”

Looking back over their ordeal, Nicola and Clifford have already found a silver lining. “If we had not gotten the misdiagnosis before Madison was born, we would not have met Dr. Khoury when we did, and he saved her life,” Nicola said.

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