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Brian has Bladder Pressure Studies

Cartoon of Brian playing football in a park

Written by Dot Mackinlay & Christine Rhodes

Brian Peter Smith was six years old and the best football player in the class. He liked school... most of the time. Most of all he liked playtime when he could play... you guessed it... football. Brian was so good that even the bigger boys let him play with them sometimes.

Cartoon of Brian heading a football

Sometimes though, Brian missed these games because he did not feel well enough to go to school. At these times, his tummy hurt so much and it was really uncomfortable when he tried to have a wee. Sometimes he even had accidents and wet his pants. He felt miserable when this happened and his mum had to give him lots of cuddles to help him feel a bit better. His mum had taken him to the doctor and the doctor had felt Brian’s tummy to see if it hurt when it was touched. She also checked the sample of wee that they had taken with them. She told Brian he had an infection in his wee and explained what this meant. Then she gave his Mum a prescription for some medicine. The medicine helped and Brian’s pain went away but after a while it all happened again. When this happened, Brian’s Doctor checked him again and gave him some more medicine but explained that he should go to the hospital to see if they could find out why it was happening so often.

Doctor shows Brian diagram of kidneys and bladder

Brian liked it at the hospital because there were lots of toys to play with. The doctor there was very nice but his hands were a bit cold when he felt Brian’s tummy. He said he wanted Brian to have more tests to find out what was happening to his wee. He asked if Brian knew how wee was made and what happens to it in his body. Brian wasn’t sure so the doctor explained. First, wee is made in the kidneys. Brian did not know what or where his kidneys were. The doctor said they are tucked inside his tummy somewhere at the back. There are two, one on each side. The kidneys help to keep the blood healthy. Once the kidneys have made the wee, it trickles down some tubes (called ureters) into the bladder. The bladder is a bit like a balloon which gets bigger as the wee trickles into it and when you go to the toilet the bladder squeezes the wee out through a tube called the urethra. The doctor drew all this on a piece of paper which he gave to Brian.

The doctor had said that he wanted Brian to go for a bladder pressure study. They were told that an appointment would be sent to him and there would be some information about this with the letter. When the appointment letter came they circled the date on the calendar in red pen to help them remember.

On the day before the red circle, Brian began to get worried. He asked his mum to explain again what would happen at the hospital. They looked at the sheet of paper about the test and decided that there were some good bits and some not-so-good bits.

Cartoon of Brian in X-ray with his mother

The good bits were that they could go to the hospital and be home for tea. Mum would be able to be with him all the time.

The not-so-good bits were that he had to go to the x-ray department. Brian couldn’t decide whether it would be exciting to see all the machines that took pictures of your insides or whether it would be a little bit frightening to lie on a table with lots of big cameras and a T.V. screen with lots of people around him. Mum reminded him that she would be there all the time so there was no need to be frightened about all the new things he would see.

She explained that when he was ready for the test, he would go into the room with the X-ray cameras where he would have a wee on a special toilet. This special toilet could measure how much he is able to wee. Mum explained that what they wanted to do during the test was to look at the bladder when it was full and as it was emptying to see if there was any problems with that. At the same time they would test the pressure of the bladder – to see if it could squeeze well enough.

That sounded reasonable enough to Brian at first but then he said “You said I had to go for a wee before the test so how can they look at my bladder when it is full?”

“Well I don’t know exactly” said Mum, “But I have to say it sounds like one of the not-so-good bits. They will fill your bladder with some clear liquid and look at your bladder on the X-Ray film while it is filling up. Then they will ask you to stand up and do a wee so that they can watch what happens to your bladder while you’re doing that.”

“I’m not doing a wee with all those people watching” said Brian not knowing whether to get angry or cry.

Mum gave Brian a big cuddle and reminded him how much pain he had when he had an infection and how he had said that he never wanted to have that again.

She also reminded him how embarrassed he felt when he wet his pants. She explained that the test would help the doctors and nurses find out more about his problem so that he could be helped. She pointed out that the doctors and nurses would be looking at the screen rather than him when he was doing his wee so it wasn’t quite so embarrassing as he thought.

Cartoon of Brian in X-ray singing with his mother

“I still don’t like it.” said Brian.

“I don’t blame you” said Mum. “But remember it only takes a few seconds to do a wee, so that bit will be over before you could count to ten. I know, during that bit, we could maybe sing the same song in our head and see if we both get to the same bit when you finish.”

It all sounded horrid but Mum gave him lots of cuddles and reminded him how important it was for getting rid of his pain. If they could do that, it would mean more football games with the bigger boys so maybe it would be worth it. On the day of the Bladder Pressure Study, Mum explained everything to Brian again.

At the hospital, Brian held his Mum’s hand tightly as they went to the ward. They went to the desk to say that they had arrived. A friendly nurse said that Brian could play with the toys in the play room and showed Mum where she could have some coffee.

Cartoon of Brian in his dressing gown

Soon it was time for him to change into his pyjamas. It seemed funny to put them on during the day. At least he could wrap up in his own dressing gown, which Mum had brought and luckily it still had his pictures of footballers in the pocket.

Brian was told that he would have to take some antibiotic medicine. Mum explained that the medicine was to stop him getting an infection and he agreed that it was probably worth it.

Their special nurse took them to the X-ray Department. They went into a huge room which had lots of big machines and a large table in the centre. About 5 people were there, the doctor who did the tests (the radiologist), the people who worked the machines (the radiographers) and another nurse. The nurse smiled and explained what would happen while the others got everything ready. She explained that Brian would need to lie on the big table. Mum would have to wear a big heavy apron like the nurse.

Once there, he had to have his wee in the special toilet he had heard about, then, once lying on the table, they would clean around his private parts with something like a baby wipe. This would be a bit cold but it was very important as it was to make sure there were no germs around there. Then they would place one very thin soft tube into Brian’s bladder through the hole that his wee came out and another one into his bottom when the poo comes out.

She said the tubes would feel strange and just hurt a little but nothing like as much as I was when Brian had the pain. She told him if he could relax and think of something else the tubes would go in much more easily.

Mum gave his hand a quick squeeze and told him he was doing well. She explained that all his muscles would be a bit tight like his hand and that they should try to do something that would make him feel all floppy and relaxed like the nurse had said.

The table was a bit hard and cold but luckily, the bit he had to lie on had a warm soft sheet on it. He lay on his back and his Mum sat near his head and held his hands. Brian had to stay very still to help with the test but Mum talked to him to help him relax.

The doctor lifted Brian’s gown and shone a bright light on his tummy. Brian felt a little frightened but knew what was going to happen, so he carried on listening to Mum who was telling him about the footballing birthday party they were planning. Brian closed his eyes and tried to imagine the things his Mum was describing and soon he was joining in telling her what he imagined happening during his game of football.

Cartoon of Imagining playing football

He could hear the doctor telling him that he was going to wipe away the germs and he would feel that it was cold. He pretended it was a splash from a puddle which had wet him while he was going for the ball.

The doctor said “I’m putting the tube in now.” Brian felt a sharp feeling which he didn’t like but he took some deep breaths like Mummy said and the feeling went. The tubes were in. They felt funny but didn’t hurt.

Brian knew that it would be the tube in his bottom next. He tried to stay still and listen to Mummy as she described different kinds of birthday cakes that he could have at his party.

“Nearly half way now” said the nurse “And that’s the worst bit over. You were very brave Brian and so good to lie so still without wriggling.” Brian tried to smile but he was still a little bit scared.

The doctor then put the small camera over the top of Brian. It was nearly as big as the rabbit hutch in next door’s garden. The camera was held over and made some clicking and whirring sounds and Brian saw that on the TV screen there were pictures in black and white. They made no sense to him or Mum but the others looked at them with interest.

Cartoon of Brian uncomfortable on his side

The doctor said that they were going to fill his bladder through one of the tubes and that it would make Brian feel as if he wanted a wee, he wasn’t supposed to wee though until they had taken some pictures of his bladder. First they took pictures as he lay on his back. He tried to think about football but he really wanted to wee. Then they helped him to roll on to one side for more pictures. Still he wanted a wee. Then he was helped onto his other side. They took more pictures. Brian could think of nothing else but having a wee. He was desperate.

The nurse helped him onto his back again and at last the doctor said “The table is going to move now Brian. It’s a bit like a fairground ride and it will move gently until you are standing up. Don’t worry you won’t fall off. Once you’re standing up we’ll take one of the tubes out and you can have a wee at last”.

Brian stood up and was so desperate for his wee he didn’t have chance to sing his pop song as he planned with Mum but he could see her lips moving and he knew which bit of the song she reached when he stopped. The nurse took away the container he had weed into.

All this time the camera was making lots of noises, clicks, whirrs and the occasional clunk and it took lots of pictures.

“Brian you have been terrific” said one of the Radiographers.

“We’ve got to take the other tubes out now. It’s much easier than putting them in. It doesn’t hurt but it does feel a bit peculiar. Try doing whatever it was you did with Mum before. That helped you relax.”

“We were planning my birthday Party.” said Brian. “That sounds fun” said the nurse. “Maybe you could imagine playing with some of the presents you might get and by that time we should have finished.”

Brian liked that idea and while he and Mum were talking the nurse took out the tubes.

“All over now” said the doctor. “You have been very good, Brian. Your Mum can take you for a wash and you can go home then.”

Cartoon of Brian with his certificate

His Mum gave him a great big hug and the nurse gave him a certificate to show what a brave boy he was. While he was talking to the nurse the doctor talked to his Mum about the pictures. Soon they were off. In the changing rooms, Mum washed him down and dried him with a towel and Brian put on his clothes. It felt good that it was over and that he had done so well. He looked at his certificate.

“Look Mum – Bladder Pressure Study. BPS, just like me.”

“So it is” said Mum. “Well Brian Peter Smith, let’s go home and have some tea and we’ll phone granny to tell her how brave you have been.”

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Content compiled by members of the Children’s Renal & Urology Unit, QMC Campus, Nottingham University Hospitals.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.