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Incontinence in Children

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.
     
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. 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 Many patients, however, relapse once the medication is withdrawn.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
Bladder training consists of exercises for strengthening and coordinating the 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, such as every 2 hours (timed voiding)
  • 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 that is 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. This may require having another person sleep in the same room to awaken the bedwetter.
 
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