Varicoceles

A varicocele means there is enlargement of the veins in the scrotum caused by stasis of blood flow. The stasis can cause blood to pool in the vessel until the vessel wall begins to bulge, and the scrotal sac swells. Though it may appear earlier, a varicocele usually develops around the age of 15 (puberty) and often occurs on the left side.

 
What are the signs or symptoms of a varicocele?

If your son has a varicocele, he may not experience any pain or swelling, except perhaps during physical exercise. While bathing, he might notice a large vein in his scrotum, or that one testis is smaller than the other. Varicoceles are sometimes discovered during routine physical examinations.

 
How are varicoceles treated?

If a varicocele is found during a physical examination by your child’s primary care physician, your child will be referred to a pediatric urologist. Your Nemours urologist will do a comprehensive evaluation of your child’s condition, including a physical examination and medical history.

If there’s concern about the size of the testis, your doctor will order a scrotal/testicular ultrasound. Based on this test, the doctor will discuss treatment and therapy options for your child.

If your son isn’t experiencing pain or discomfort, the recommendation may be to closely monitor growth and development of the testes as he goes through puberty.

If there is a significant difference in the size of the two testes, or if your son is experiencing pain, then surgical correction may be indicated. Nemours urologists can usually do this as an outpatient procedure, and in a few weeks your son can get back to normal activities.

Bedwetting

What Is Bedwetting?

Bedwetting is when kids who are old enough to control their bladder pee at night during sleep. It's a common problem in kids, especially those under 6 years old. 

Why Does Bedwetting Happen?

Doctors don't know for sure what causes bedwetting or why it stops. But it's often a natural part of development, and kids usually grow out of it. It's most common in young kids, but can last into the teen years. Most of the time, bedwetting is not a sign of any deeper medical or emotional issues.

Bedwetting often runs in families: many kids who wet the bed have a relative who did too. If both parents wet the bed when they were young, it's very likely that their child will.

How Can We Cope With Bedwetting?

Bedwetting is an issue that millions of families face every night, and can be very stressful. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.

Bedwetting usually goes away on its own, but may last for a while. It can be embarrassing and uncomfortable for your child, so it's important to provide emotional support until it stops.

Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about any other family members who struggled with it when they were young.

Try to have your child drink more fluids during the daytime hours and less at night (and avoid caffeine-containing drinks). Then remind your child to go to the bathroom one final time before bedtime. Many parents find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

When your child wakes with wet sheets, don't yell or punish. Have your child help you change the sheets. Explain that this isn't punishment, but it is part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.

When Should I Call the Doctor?

Bedwetting that begins suddenly or happens with other symptoms can be a sign of another medical condition, so talk with your doctor.

The doctor may check for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes, or severe stress.

Call the doctor if your child:

  • suddenly starts wetting the bed after being consistently dry for at least 6 months
  • begins to wet his or her pants during the day
  • snores at night
  • complains of a burning sensation or pain when urinating
  • has to pee often
  • is drinking or eating much more than usual
  • has swelling of the feet or ankles
  • is 7 years of age or older and still wetting the bed

Also let the doctor know if your child is under a lot of stress, if you're feeling frustrated with the situation, or if you could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about and overcome the bedwetting.

Remember, the long-term outlook is excellent and in almost all cases, dry days are just ahead.

Reviewed by: Marcella A. Escoto, DO
Date reviewed: April 28, 2017