About the DOVE Center for Voiding and Bladder Function

Wetting accidents, frequent urinary tract infections, or constipation can be upsetting for you and your child. At the DOVE (Dysfunctional Outpatient Voiding Education) Center at Children's Hospital of Philadelphia, we will sort out what is causing these problems and develop a plan to correct them.

The DOVE Center is among the largest, most comprehensive clinics in the United States devoted to pediatric bladder and urinary tract dysfunction. Our team includes urologists, nurse practitioners, nurses and psychologists. Our program treats children with:

• Daytime or nighttime wetting
• Urinary urgency
• Urinary frequency
• Constipation
• Recurrent urinary tract infections (UTIs)

What to expect

At your child's first appointment with the DOVE Center, a physicians or nurse practitioner will take a thorough history of your child’s symptoms and other medical conditions. We will want to know how often your child goes to the bathroom, how often he has accidents, and whether he has a history of urinary tract infections. It is helpful to bring a record of your child’s recent bathroom habits to the first appointment. We will also conduct a physical examination of the abdomen, spine and genitals. 

After meeting with you and your child, we may recommend one or more tests to confirm his diagnosis and establish a treatment plan. The tests your child may undergo include:

• Uroflow
• X-ray of the abdomen (also known as a KUB) to determine if your child is constipated, as incontinence and constipation often occur together. Treating the constipation can lead to a dramatic improvement in wetting.
• Ultrasound to assess the size and shape of the kidneys and looks for bladder abnormalities
• Video urodynamic study (VUDS)

Based on the results of your child's evaluation, our DOVE Center team may then suggest a variety of treatment approaches, including:

• Changing voiding/stooling habits: We commonly recommend that children start stool softeners in order to treat any underlying constipation. We will also work with parents to help them develop a schedule with their child that incorporates regular voiding and stooling throughout the day.
• Increasing fluid intake: Families often restrict fluids to help control the wetting. However, it is important to teach your child to drink water throughout the day. We will explain to your child why drinking water is important and make recommendations as to how much water she should drink each day.
• Biofeedback training: A way to teach your child to relax the pelvic floor muscles so his bladder can empty completely, biofeedback is effective in helping children learn to empty their bladder completely — reducing urgency, wetting, and recurrent urinary tract infections.
• Behavior modification: Our psychologists work with you and your child to provide education about how the body works and why children need to follow the recommended treatment. We are among only a few pediatric urology programs in the nation with psychologists embedded in our clinic who are dedicated to helping children with daytime and nighttime wetting.
• Medication: We use medications most frequently to treat frequent urinary tract infections in children with overactive bladder and in children with nighttime wetting.