Urinary Incontinence in Children (cont.)
David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Urinary incontinence in children facts
- What is urinary incontinence?
- How does the urinary system work?
- What are the different types of urinary incontinence?
- How common is urinary incontinence in children?
- What causes nighttime incontinence in children?
- What causes daytime incontinence in children?
- How do you differentiate between organic and nonorganic causes of urinary incontinence?
- What is the treatment for urinary incontinence in children?
- What is the prognosis of urinary incontinence in children?
- Where can people get more information on urinary incontinence in children?
- Find a local Pediatrician in your town
What is the treatment for urinary incontinence in children?
The treatment of urinary incontinence depends upon the underlying cause of the problem. The primary treatment for nocturnal enuresis most commonly involves behavioral modification. This involves positive reinforcement, encouraging frequent daytime voiding, and periodically waking the child at night, restricting fluid intake prior to bed, and alarm therapy with devices that wake the child when the underwear or bedclothes have become wet. In all cases, most children are already embarrassed by bedwetting and it is important try to reduce the social and psychological impact of the condition. Moisture alarm therapy has a 70% success rate and works best for motivated older children and parents. The basic process involves placing a probe in the undergarments or bed which alarms when it senses wetness. Most children will sleep through the alarm; however, most stop voiding when the alarm goes off. The child's parent must get up and help the child to the bathroom to encourage voiding, change the wet sheets and pajamas, and reset the alarm. Moisture alarms generally work within two weeks to three months and should be discontinued if the child's symptoms persist after three months.
In addition to behavioral modification, there are some children who will ultimate require medication. Most commonly used medications include desmopressin acetate (DDAVP), oxybutynin chloride (Ditropan), hyoscyamine sulphate (Levsin), and imipramine (Tofranil). All of these medications have significant potential for side effects, should be reserved for a very select population, and should be used to treat the symptoms not as a cure, while awaiting natural resolution. Medications can be used intermittently for children who attend overnight camp or for sleepovers since these are 70% effective in preventing the symptoms, and bedwetting in these environments can be humiliating and stress-producing for children.
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