I recently saw an 11 year old girl with a history of wetting daily for most of her life. Any urologic testing that had been done was normal and she had never had a urinary tract infection. She wore an adult woman's panty liner every day to school and both she and her mother felt this was something she would just have to do the rest of her life. They did not know there were options available to help her.
An important piece that was identified during taking her history was that she had infrequent bowel movements, 2 or 3 times a week. She was reluctant to go at school. Constipation often goes along with daytime wetting so we worked hard on correcting this. A high fiber diet, increased water intake during the day and Miralax every morning quickly made a huge difference in the frequency and consistency of her bowel movements.
Along with this, we instituted a timed voiding program, using the Rodger 8 alarm vibrating watch set to vibrate at convenient intervals, about every two hours. We made sure the right times were set so that she started PE, lunch and the bus ride to after care all with an empty bladder. A 5:30 pm and 7:30 pm time made sure she voided while her mother was busy preparing dinner and doing evening chores.
Although a little skeptical at first, both parents and daughter were willing to cooperate with the instructions. At two weeks, stools were much improved and her panty liner was no longer soaked. When I described our goal of getting rid of the daytime panty liner, she expressed nervousness about doing that. We implemented a plan of going without a panty liner on weekends first so that she could prove to herself that she could stay dry with the timed voiding program in place. During a follow-up call one month later, mom described her success at staying dry during the day, no panty liner and a huge boost to her self-confidence. She can continue this regimen for the next few months, until her body is able to do the alerting.
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