Conditions — Children

During the development of a fetus, the testicles (male sex organs) form near the kidneys. As the fetus grows, the testicles descend (move down) into the scrotum. Normally, they’re in the scrotum before the baby is born. An undescended testicle doesn’t fully descend into the scrotum.

Locating an Undescended Testicle

The undescended testicle can usually be felt during a physical exam. Your baby lies on his back for the exam. An older child may be asked to squat. The doctor places his or her fingers on the child’s groin and then gently moves them toward the scrotum until the testicle is felt. If the testicle can’t be found with an exam, imaging studies, such as ultrasound, or other special tests may be needed.

Watchful Waiting

The doctor will most likely wait for a few months to see if your son’s testicle will descend on its own. The closer the testicle is to the scrotum, the greater the chance it will come down. If the testicle does not descend on its own, it can still be treated. If both testicles have not descended, or if the testicle is above the groin, the doctor may advise treatment.

If the testicle doesn’t descend on its own, it should be treated to prevent future problems. Surgery is done to bring an undescended testicle into the normal position within the scrotum.

Why Treatment Is Needed

• The longer a testicle remains outside the scrotum, the more likely it is that it will produce fewer sperm.
• An undescended testicle has a higher risk of cancer. This is true even after the testicle is brought down into the scrotum. Bringing the testicle down makes a problem easier to find.
• An undescended testicle can leave a small tear (hernia) in the wall between the abdomen and the groin. The hernia needs to be treated to prevent future problems.

Surgery

The testicle is brought down into the scrotum during surgery.

• You and your son are asked to arrive at the hospital or surgery center 1-2 hours before surgery.
• Anesthesia is given to keep your son comfortable.
• An opening (incision) is made in the groin or abdomen. Another small incision is made in the scrotum.
• The testicle is detached from the tissue around it. Then it is brought down and stitched to the wall of the scrotum.

After Surgery

Your son will most likely go home a few hours after surgery. He should be feeling better in 2-3 days.

• The doctor may prescribe medication to relieve any pain your child has. Be sure to use it as directed.
• The stitches will dissolve or be removed 7-10 days after surgery.

Call Your Doctor If:

• The incision bleeds or becomes red, or there is a discharge from the incision.
• A fever over 100.2°F.
• The child cries all the time.

Bedwetting, also called nighttime enuresis, affects many children, teenagers, and even some adults. It can be frustrating. But it’s usually not a sign of a major problem. This sheet will help you and your child understand bedwetting and what can be done to overcome it.

Is Something Wrong?

Probably not. Bedwetting is rarely due to a physical problem. For many kids who wet the bed, their bladders simply need more time to mature. Some kids also sleep so deeply that they don’t wake up when they need to use the bathroom. If a child wets the bed after being dry for a while, the cause is often a lifestyle change (such as starting school) or a stressful event (such as the birth of a sibling).

What Can We Do?

Bedwetting is not your child’s fault. Getting mad or upset won’t help. But don’t ignore the problem, either. Instead, work together to cope with bedwetting. Start by visiting the doctor. This way, health problems that may be causing bedwetting can be ruled out.

Questions That May Be Asked

Your child’s healthcare provider may ask the following questions:

• How often does your child urinate? How much?
• What color is your child’s urine?
• Are there any symptoms while urinating, such as burning or pain?
• Has your child had any constipation or daytime accidents?
• Does your child have any health problems?
• Were any other family members bedwetters?
• Has bedwetting affected your child’s self-esteem or relationships with other kids?

Your Child’s Evaluation

An exam will be done to look for physical problems. Your child’s urine may be tested for infection. You and your child may be asked to keep a log of his or her urinary patterns for a few days.

Most kids outgrow bedwetting over time, which means patience is the best cure. The doctor may suggest ways to speed up the process. This includes the ideas outlined on this sheet.

The Self-Awakening Routine

To overcome bedwetting, your child must learn to wake up when it’s time to urinate. These tips will help:

• If your child wakes up for any reason, he or she should get out of bed and try to use the toilet.
• If your child wakes and the bed is wet, he or she should help change the sheets and wet pajamas before returning to bed.
• Each evening, have your child lie on the bed, pretending to sleep, and imagine he or she has to urinate. The child should get up, walk to the bathroom, and try to urinate. This helps teach the habit of getting out of bed to use the toilet.

Bedwetting Alarms

A specially designed alarm may help teach a child to wake up to urinate. These are available at drugstores, medical supply stores, and on the Internet. Bedwetting alarms help your child learn to wake up to use the bathroom. Here’s how they work:

• The alarm contains a sensor. It attaches either to the underwear or to a pad on the bed. A noisy alarm may be worn around the wrist or on the shoulder near the ear. Or, a vibrating alarm may be placed under the child’s pillow.
• If the child begins to urinate, the alarm goes off. This wakes the child up. He or she can then get up and use the toilet.
• Some children sleep through the alarm at first. You may need to wake your child when you hear the alarm.

Other Lifestyle Changes

• Limit all liquids in the evening. This may help keep the bladder empty during the night. (Don’t limit drinks altogether. This can cause dehydration. Instead, have your child drink more during the day and less in the evening.)
• Limit caffeinated drinks (such as colas and other sodas) at dinner. Caffeine stimulates urination. Also limit chocolate, which contains caffeine.
• Encourage your child to use the bathroom regularly during the day.

Medications

Medications come in nasal spray, pill, or liquid form. They may reduce the amount of urine the body makes overnight. They may also help the bladder hold more fluid. Medications can give your child extra help staying dry during vacations or overnight stays away from home. But keep in mind that medications don’t cure bedwetting, and they’re not a long-term solution. Also, medications can have side effects. Talk to the doctor about using them safely.

Bedwetting isn’t something your child does on purpose. Never punish or tease a child for wetting the bed. This could make the problem worse by making your child feel ashamed and embarrassed. Instead, be positive and supportive. Praise your child for success and even for trying hard to stay dry.

Tips That May Help

• Get your child involved. Encourage your child to take responsibility for changing a wet bed during the night.
• Put up a calendar or chart and give your child a star or sticker for nights that he or she doesn’t wet the bed.
• Put night lights in the bedroom, hallway, and bathroom. These may help your child feel safer walking to the bathroom.
• Keep a plastic bag or laundry basket in the room to hold wet sheets and pajamas.
• Protect the mattress with a waterproof cover. Put an absorbent pad on the bed or keep extra sheets or dry towels in the room. If the child wets during the night, he or she can get up and remove the pad, change the sheets, or put a dry towel over the wet spot.
• Make overnight trips as easy as possible. If your child goes to a slumber party, hide a disposable diaper in the bottom of the sleeping bag. This can be slipped on under his or her pajamas. Also ask the doctor about medications that may help control bedwetting for a night or two.
• Keep in mind that waking your child up to use the bathroom may prevent a wet bed that night. But it won’t make your child outgrow the problem any faster.

Growing Up

Children mature at different rates. Some kids don’t walk, talk, or grow as quickly as others. And some take longer to stop wetting the bed. This doesn’t mean something’s wrong. With your patience and understanding, your child can overcome bedwetting, without hurting his or her confidence or self-esteem.