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Growth and development
Most urinary incontinence fades away naturally. Here are examples of what can happen over time:
* Bladder capacity increases.
* Natural body alarms become activated.
* An overactive bladder settles down.
* Production of ADH becomes normal.
* The child learns to respond to the body's signal that it is time to void.
* Stressful events or periods pass.
Many children overcome incontinence naturally (without treatment) as they grow older. The number of cases of incontinence goes down by 15 percent for each year after the age of 5.
[edit] Medications
Nighttime incontinence may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin, or DDAVP, which recently became available in pill form. Patients can also spray a mist containing desmopressin into their nostrils. Desmopressin is approved for use by children.
Another medication, called imipramine, is also used to treat sleepwetting. It acts on both the brain and the urinary bladder. Unfortunately, total dryness with either of the medications available is achieved in only about 20 percent of patients.
If a young person experiences incontinence resulting from an overactive bladder, a doctor might prescribe a medicine that helps to calm the bladder muscle. This medicine controls muscle spasms and belongs to a class of medications called anticholinergics.
Bladder training and related strategies
Bladder training consists of exercises for strengthening and coordinating muscles of the bladder and urethra, and may help the control of urination. These techniques teach the child to anticipate the need to urinate and prevent urination when away from a toilet. Techniques that may help nighttime incontinence include
* determining bladder capacity
* stretching the bladder (delaying urinating)
* drinking less fluid before sleeping
* developing routines for waking up
Unfortunately, none of the above has demonstrated proven success.
Techniques that may help daytime incontinence include
* urinating on a schedule, such as every 2 hours (this is called timed voiding)
* avoiding caffeine or other foods or drinks that may contribute to a child's incontinence
* following suggestions for healthy urination, such as relaxing muscles and taking your time
Moisture alarms
At night, moisture alarms can awaken a person when he or she begins to urinate. These devices include a water-sensitive pad worn in pajamas, a wire connecting to a battery-driven control, and an alarm that sounds when moisture is first detected. For the alarm to be effective, the child must awaken or be awakened as soon as the alarm goes off. This may require having another person sleep in the same room to awaken the bedwetter.
Incontinence is also called enuresis
* Primary enuresis refers to wetting in a person who has never been dry for at least 6 months.
* Secondary enuresis refers to wetting that begins after at least 6 months of dryness.
* Nocturnal enuresis refers to wetting that usually occurs during sleep (nighttime incontinence).
* Diurnal enuresis refers to wetting when awake (daytime incontinence).
Points to remember
* Urinary incontinence in children is common.
* Nighttime wetting occurs more commonly in boys.
* Daytime Wetting is more common in girls.
* After age 5, incontinence disappears naturally at a rate of 15 percent of cases per year.
* Treatments include waiting, dietary modification, moisture alarms, medications, and bladder training.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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