Wetting, Infections, and Stooling Help (WISH)

Many children suffer from urinary tract infections, bedwetting, daytime incontinence (wetting), painful or difficult urination, urinary frequency, urgency, penile and vaginal pain. Bowel and bladder dysfunction (voiding disorders) are fairly common in children, and our dedicated team is here to help.

The Wetting, Infections and Stooling Help (WISH) Clinic at Children’s National Hospital helps parents and kids successfully overcome urinary tract problems. The WISH Clinic at Children’s National is dedicated to resolving recurrent urinary tract infections and wetting problems in children through a comprehensive and holistic interactive process.

With a number of locations throughout Washington, DC, Maryland, and Virginia, the WISH Clinic is led by Naida Kalloo, M.D., who works alongside three nurse practitioners, a clinical nurse specialist, and a pediatric urology nurse. Together, this group evaluates patients by performing in-depth, 30-minute assessments to address specific problems, such as bedwetting, daytime leakage, urinary infections and associated constipation.

Wetting, Infection and Stooling Help at Children’s National

There is no one cause for urinary tract problems in children, and so there is no one treatment. At Children’s National, the experienced staff at our WISH Clinic takes the time to evaluate your child and give a range of options for treatment.

Features of our WISH program include:

• Expertise: Our team includes a board certified pediatric urologist, a pediatric urology nurse, nurse practitioners and a clinical nurse specialist.
• Comprehensive evaluations: We perform a thorough, 30-minute evaluation to help us create a treatment plan designed for your child and his or her individual needs.
• Personalized treatment plans: We outline treatment regimens in detailed, take-home handouts that we review with you during your visit.  We provide families with additional sources of information so they can learn more about causes and options beyond what is possible during the clinic visit.
• Convenient, local services: Clinic appointments are available at the medical center and at several of our specialty care locations throughout Maryland and Virginia.
• Biofeedback Therapy: Non-invasive muscle retraining therapy utilized for children who have difficulty controlling the muscles used to void or have a bowel movement. Advanced biofeedback technology helps children to learn to use their muscles correctly leading to improvement in overall bladder function.

"The WISH Clinic provides a template that allows for extensive evaluation of and counseling for these conditions, which account for about 15 percent of all outpatient urology references,” says H. Gil Rushton, M.D., division chief of Urology at Children’s National. "This comprehensive process offers a much better experience for patients and their families in comparison to being seen in a busy urology clinic. It is an invaluable part of the Division of Urology at Children’s National."

Tests conducted by the WISH Clinic may include a comprehensive history and physical exam, a bladder scan, and urinalysis. Additionally, some cases require more in-depth tests, such as an abdominal X-ray, a renal bladder ultrasound or urodynamic studies to measure bladder function.

WISH Clinic Evaluations: What to Expect

We schedule all appointments for 30 minutes so we can take the time to fully evaluate your child and discuss treatment options with you.

Once WISH Clinic experts have determined the factors causing urinary and bowel complications, they work with parents to design treatment plans and provide educational materials for home reference.

Most children with bladder and bowel dysfunction will not require invasive testing or radiologic studies. During your visit, your child’s evaluation will include one or more of the following:

• Comprehensive physical exam and medical history
• Completion of a bladder and bowel questionnaire
• Urine testing
• Bladder scan, in some cases

For more involved cases, we may recommend the following:

• Renal bladder ultrasound with pre- and post-void images
• Abdominal X-ray
• Uroflow/EMG or urodynamic studies to help us evaluate how well the bladder works as it fills and empties.

Uroflow and urodynamic tests are available only at the Sheikh Zayed campus (Children's National).