Posts Tagged ‘toileting’

Bed Wetting Problem

Tuesday, February 23rd, 2010

RA writes, I hope you can help with my son’s bedwetting problem. My almost 10 year old boy is a major bedwetter and I mean he wets 3-4 times per night. He has been seeing a urologist and the biofeedback determines he is not an efficient voider during the day- he does not empty his bladder completely. So all this urine builds up all day long and he wets at night. He is supposed to be doing kegel type exercises. We have tried the alarm for six months and it does not help. He was on medication for nighttime but it made no difference. He is a heavy sleeper and we end up getting up. He double voids before bed and we limit liquids. What else can we do? I am at my wits end! I feel he will be 16 before this ends!

Bedwetting can be so frustrating at times. It sounds like you have explored many avenues to get your son to dryness. Since it sounds like his daytime voiding is inefficient, working on that a little more may help. Did the urologist recommend a timed voiding program in the daytime? The kids wear a vibratory wristwatch that discreetly reminds them to go to the bathroom about every 2 hours, even if they don’t feel like it. If he hasn’t tried this yet, it may help to empty his bladder more efficiently during the day. I use the Vibrowatch for my patients because it can be set to precise times. I like to set times that do not require the kids to leave the middle of class, and allow them to start the bus ride home at the end of the day with an empty bladder. Taking a water bottle to school helps to assure that they are adequately hydrated during the day and not thirsty late in the day. Once he’s done this for a few months, he could restart the alarm at night.

School Wetting

Tuesday, August 18th, 2009

EP writes about her 7 year old daughter who will be starting 2nd grade soon. In first grade, there were times that she waited until the last minute and didn’t make it to the bathroom in time. This resulted in wet pants, sometimes requiring a complete change of clothes. She has been checked out by her doctor and there does not seem to be any associated problems. Mom wonders what she can do to prevent this from happening this school year.

Urologists around the country agree that this can be a common and frustrating problem that is best handled by frequent urination on a regular basis. Emptying the bladder regularly eliminates the urgent messages that sometimes result in urine leakage. The difficulty arises when children get busy with other activities and lose track of time. Telling a child to go potty every 2 or 3 hours is a hard concept to grasp. Even remembering to go to the bathroom before lunch or recess can be difficult. A discreet vibrating wrist watch is a reliable tool for providing a reminder to go to the bathroom.

We carry several vibrating wrist watches that are perfect for this purpose. Our top selling watch is the Vibrowatch. Up to 12 specific times can be programmed to coordinate with your daughter’s schedule. The watch vibrates for about 20 seconds and is difficult to ignore. It comes in several different colors and has a durable plastic band. Vibrating watches are generally a little larger than time telling watches to accommodate the larger battery.

Starting the new school year off with a reminder watch is likely to eliminate many of the embarrassing accidents she had last year. You can consult her teacher about the best toileting times and make sure she has free access to the bathroom when her watch reminds her to go.

Daytime Wetting

Friday, January 9th, 2009

I want to share some effective strategies for school aged children with daytime wetting or leaking.  Daytime wetting is a little more common in girls, and nighttime wetting is a little more common in boys, but both sexes can be affected. The children often describe that they don’t feel like they need to go to the bathroom until the last minute. Then it’s too late and urine begins to come out in their underwear. Parents describe the frustration of noticing that their child is fidgeting or reminding them to go to the bathroom, with their child responding “I don’t have to go”. Five minutes later, urine is leaking out or they are urgently trying to find a bathroom.

Making sure that the urine/urinary tract is normal is always prudent when noticing this behavior. You can consult with your pediatrician about this. Also, constipation and infrequent stools can contribute to daytime wetting problems. Address these factors first. If neither of these things is found to be contributory, you can move on to some behavioral techniques.

It seems that when these children’s bladders become overly full, they sent a very urgent message to the brain and begin contracting before the child has a chance to get to the bathroom. Parents describe this as “waiting until the last minute” or being so interested in play that they “ignore needing to go to the bathroom”. You and I receive messages from our bladder well in advance of actually needing to use the bathroom. We have time to finish what we’re doing and leisurely make our way to the toilet. Children with daytime wetting often don’t have this luxury.

We know that “timed voiding”, which is emptying the bladder on a schedule, rather than waiting for internal messages, is very effective in preventing overfull bladders from sending urgent messages. It’s almost impossible for a child, who has little comprehension of time, to remember to “Go to the bathroom every 2 hours”. A discreet, independent reminder can make all the difference.

Using a vibratory wristwatch is a great way of fostering the independent behavior of going to the bathroom on a regular schedule. Usually around every 2 hours is a good amount of time to begin with. For school age children, I prefer watches in which you can set specific times. That way, you can coordinate with the teacher the times that would be less disruptive but allow him/her to start p.e., recess or lunch with an empty bladder. Voiding at the end of the school day allows your child to begin the trip to home with an empty bladder, eliminating accidents on the bus or running to the bathroom when entering the house.

The Vibrowatch offers 12 independent times and vibrates about 20 seconds, making it difficult to ignore. The Medose and WobL watch each offer 6 independent alarms, and vibrate for 20 and 5 seconds, respectively. You can watch these videos to get a better idea of how these watches work. Most of my patients are amazed at how well their children do once they’re given a simple tool to help.