Large Bladder Capacity
If your child has a larger than normal bladder capacity, he may not be emptying his bladder completely when he urinates. To help him do so encourage your child to be patient while at the potty, so that he empties he's bladder. You may even ask him to return to the potty and urinate again just a few minutes later, Note: large bladder capacity is not typical of routine bedwetting, so be sure to consult your doctor.
Urge Syndrome
Most children with this problem are between four and nine years old. Their stories are similar, parents report that their child has always been healthy and dry, but i the past few months he had begun to visit the potty often and experiences great urgency. If the child doesn't get there in time, he wets. Paradoxically, though, the child ether sleeps through the night with out wetting or gets up to urinate in the bathroom.
In many children, this increased frequency and urge results from a reduced functional bladder capacity or from a inflammation of the bladder. What causes this inflammation, called nonspecific cystourethritis, is not clear. It seems likely that something like a viral infection is behind it.
For example, children tend to get sore throats, and sometimes we find that bacteria cause the soreness, but other times we find no bacterial culprit and conclude that the cause must be a viral infection. Likewise, a child's bladder is prone to inflammation not related to bacteria. But unlike a sore throat, which usually gets better within a week, the bladder may stay inflamed fro months with out showing any signs of improvement. The infection that increases the frequency and urgency and cause the wetting may disappear, but the symptoms persist.
In such cases, the child usually benefits from a sulfa-based antibiotic combined with oxybutynin (to combat small bladder capacity and urgency). If the symptoms still don't improve, you should visit a pediatric urologist.
The Child Who Wets Only At Night
Too Frequently.
Children who bedwet commonly urinate more often than normal, throughout the day and night, particularly if the bladder capacity is small. If your child does not wet during the day but does urinate frequently while awake, he may benefit from taking oxybutynin, the same medication used to treat small bladder capacity, during the day. Oxybutynin decreases daytime frequency and eases the urgency to void that your child may feel.
Too Seldom.
If, however, your child wets only at night and urinates too infrequently, that is, if he urinates less than four time during waking hours, then daytime medication may not be necessary. Setting up a schedule for visiting the bathroom at designated times may be helpful. Taking a dose of Ditropan before bedtime may also still be helpful though.
The child who wets only in the daytime
It is most unusual for a child to wet during the day but not at night. However, because some children do experience such wetting pattern, we will cover their situation here.
Too Frequently.
For children who wet only during the day and urinate too often, and for whom incontinence has been rule out by your doctor , we recommend oxybutynin in addition to the enuresis alarm. Children who wet during the day likely have a reduced bladder capacity.If you find that this is true of your child, consult your doctor about the possibility of using oxybutynin to help your child achieve day time dryness.
In conjunction with medication and the bladder diet, we recommend that you implement a timed voiding schedule for your child. Also the child needs to wear the alarm after school during the week and most of the day during weekends as training sessions to learn dryness.
Make sure that while at school your child has a small duffel or gym bag with a change of clothes , including undergarments and a plastic bag large enough to hold wet clothes. This can be kept in the child's locker or a teacher's closet. Having dry clothes available will save your child from the embarrassment of being sent home, having to wait for you to deliver dry clothes or worst yet, being forced to sit in wet clothing until released from class.
Too Seldom.
If your child indeed has urinary infrequency, wets occasionally during the day, but does not wet at night, her toilet habits may need improvement. It could be that your child simple hold's off using the potty and wets because her bladder is over full. Some children void incompletely because they are too busy to take the time to empty their bladder. They start to void, relieve their sense of pressure, hear a stream of urine, then stop voiding to return to whatever they were engrossed in.
Consider trying a timed voiding schedule to encourage him to the toilet more frequently. While you are following the voiding schedule, continue recording in the dairy the time and amount voided, until the condition improves. Chronic delaying of urination can lead to urinary tract infection's, bowel problems, and other bladder complication, so it's important to end such a habit.
To facilitate wetting treatment for a child whose infrequent voiding contributes to day dampness or wetting at school, you may want to write a letter similar to the one below to keep teacher and other adults informed and to ask for their assistance.
Dear [teacher's name],
Its has been discover that [child's name] has enuresis, a condition that results in periodic wetting episodes during the day. As part of our attempt to help [him/her] gain control of [his/her] bladder, we have instituted a time voiding schedule, which requires that [she/he] attempt to use the toilet every hours whether or not [he/she] has the urge to go.
To keep it simple, we have instructed [him/her] to ask to be excused from class on even-numbered hours. We would appreciate it if you would see to it that [he/she] is encouraged to leave the room in a manner that is not disruptive to your class and does not draw undue attention to this sensitive issue.
If you have any questions or concerns, you can call me during the day at [phone number] or in the evening at [phone number]. Thank you.
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