OBJECTIVE: To consider a conservative management plan for a patient suffering from diurnal enuresis.

CLINICAL FEATURES: A 12-yr-old girl complained of left flank pain and involuntary urine loss that apparently began a short time after she fell backwards and landed on her coccyx. She had to wear a sanitary pad prophylactically throughout each day for more than a year because of unpredictable urinary incontinence.

INTERVENTION: Manual adjusting procedures and soft tissue therapy were applied initially. Procedures were modified later to include an intrarectal technique. The quantity of urine loss decreased slowly with the initial treatment approach but never resolved completely. The flank pain also decreased somewhat but never ceased altogether. After the introduction of the intrarectal technique, additional progress was reported and both the flank pain and urinary incontinence resolved completely. A 4-yr follow-up confirmed complete resolution.

CONCLUSION: Conservative care helped an adolescent girl suffering from traumatically induced urinary incontinence.

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