Urinary Incontinence in Children (cont.)

What treats or cures incontinence?

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.

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 is available in pill form, nasal spray, or nose drops. Desmopressin is approved for use in children.

Another medication, called imipramine, is also used to treat sleepwetting. It acts on both the brain and the urinary bladder. Researchers estimate that these medications may help as many as 70 percent of patients achieve short-term success. Many patients, however, relapse once the medication is withdrawn.

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


  • drinking less fluid before sleeping


  • developing routines for waking up

Unfortunately, none of these techniques guarantees success.

Techniques that may help daytime incontinence include

  • urinating on a schedule -- timed voiding -- such as every 2 hours


  • avoiding caffeine or other foods or drinks that you suspect may contribute to your 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 as soon as the alarm goes off, go to the bathroom, and change the bedding. Using alarms may require having another person sleep in the same room to awaken the bedwetter.

Incontinence is also called enuresis

  • Primary enuresis is wetting in a person who has never been dry for at least 6 months.


  • Secondary enuresis is wetting that begins after at least 6 months of dryness.


  • Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime incontinence.


  • Diurnal enuresis is wetting when awake, also called daytime incontinence.

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