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Childhood Incontinence Clinic in Salt Lake

Childhood Incontinence Clinic

Childhood Incontinence Clinic in Mukundapur

It is common for young children to experience bed-wetting until they reach 5 to 6 years old. However, if this persists longer, it may be a cause for concern. This could indicate ‌some urinary tract disorders, which need to be well monitored and treated accordingly. This can be well managed and diagnosed in a Childhood Incontinence Clinic. 

Childhood Incontinence Clinic, Manipal Hospital offers targeted treatment for children with problems with their bladder or bowel control. These clinics are dedicated to conducting comprehensive evaluations and modifying patient habits to diagnose and address issues with urinary and bowel incontinence. They provide families with information and support, teaching them how to manage symptoms and encourage continence. 

These clinics, which often include paediatric urologists, nurses, and therapists, emphasise behavioural techniques such as timed voiding and hydration management to enhance control. Frequent monitoring makes it easier to obtain results and modify plans as necessary. In general, the goal of Paediatric Incontinence Clinics is to improve children's quality of life by treating these common yet frequently upsetting disorders.
 

FAQ's

Enuresis is of four types, and a child can have one or more of these types:

  • Nocturnal Enuresis: This is the most common type of enuresis. This wetting occurs during the night and is called bedwetting.

  • Diurnal Enuresis: This is called daytime wetting, and wetting occurs during the day. This may be the result of certain behaviours. 

  • Primary Enuresis: This usually occurs when the child has not fully mastered the technique of toilet training.

  • Secondary Enuresis: This condition occurs when, after a period of dryness, the child returns to wetting again.

One or more of the numerous types of incontinence that can affect children include:

  • Urge syndrome: An overactive bladder is diagnosed in children who feel the need to urinate more frequently than usual, often without warning. It is sometimes associated with behaviours like crossing legs or squatting to prevent leakage.

  • Dysfunctional voiding: When the bladder tries to empty, the sphincter muscle contracts, retaining urine and making the child urinate more frequently.

  • Underactive or lazy bladder: In this condition, the bladder muscles are weak, causing incomplete bladder emptying. This can lead to infrequent urination, sometimes as little as twice a day, and an increased risk of urinary retention and infections.

  • Neurogenic bladder: A neurological disorder like spina bifida or spinal cord injury that is linked to bladder symptoms is diagnosed as a neurogenic bladder. 

There can be many possible causes of urinary incontinence in children. However, the exact cause of bedwetting is not known. Here are some of the possible causes of enuresis, including:

  • Small bladder

  • Hormone imbalance (not producing enough ADH, an anti-diuretic hormone) 

  • Diabetes

  • Urinary tract infection

  • Sleep apnea

  • Ongoing constipation that puts pressure on the bladder

  • Certain genes

  • Anxiety

  • Attention deficit hyperactivity disorder (ADHD)

  • Structural problems in the urinary tract

  • Not feeling that the bladder is full while asleep

  • Very deep sleep

  • Caffeine intake

  • Not going to the bathroom often or not urinating enough when going

Clinics evaluate these disorders in depth to identify the best management plans for each child. Paediatric Incontinence Clinics treat a range of incontinence problems in children, such as:

  • Daytime wetting (diurnal enuresis): The unintentional urine that occurs when one is awake

  • Bedwetting: Bedwetting, also known as nocturnal enuresis, is involuntary urine that occurs while you sleep, usually at night

  • Constipation-induced accidents (Encopresis): Constipation can lead to defecation that is not voluntary

  • Overactive bladder: Abrupt urogenital cravings and potential overflow

  • Incomplete emptying: Having trouble emptying the stool or bladder

Most children outgrow this condition with age, but it may remain a problem for some children after the age of 7 years, requiring help from a specialised doctor. If your child experiences any of these signs, seek medical attention.

These signs include:

  • Your child still has wet pants or bed after the age of 7

  • Starts wetting after a few months of being dry during the day or night

  • In addition to wetting, if the child experiences:

    • Pain after passing urine

    • Feels extra thirsty

    • Has hard stools

    • Snores

    • Has red or pink urine

Clinics assess children's medical history, current symptoms, and causes of incontinence. This may involve physical exams, bladder function tests, and evaluations of hydration and toileting habits. The diagnosis of urinary incontinence in children is intricate, as it entails assessing both behavioural and physical indications. Our paediatric urologists will discuss the child's bladder leakage incidents, including when they began, how often they occur, and if they've ever had bladder control. A physical exam will also be done to feel the bladder's firmness and check for signs of constipation.

The diagnosis of child urinary incontinence helps in knowing the underlying cause and condition of your child’s situation so that the right treatment plan can be made. This includes:

  • Physical exam

  • Discussing the symptoms, family history, frequency of child urinating, fluid intake, problems faced, bowel and bladder habits, stress, etc.

  • Urine or blood tests are used to assess the signs of an infection or diabetes.

  • Imaging tests or X-rays of the bladder or kidneys to assess the structural issues of the urinary tract

  • Any other types of tests, if needed

Children's Incontinence Clinics provide comprehensive, needs-specific support to children and families.

  • Education: Clinics offer information on bowel and bladder health, outlining reasons and preventative measures.

  • Behavioural strategies: They include advice on timing your voids, controlling your fluid consumption, and making dietary changes.

  • Emotional support: By providing comfort and coping mechanisms, clinics help patients deal with the emotional toll that incontinence takes.

  • Therapeutic interventions: They might suggest biofeedback treatment or pelvic floor exercises.

  • Follow-up: Consistent monitoring and modifications to treatment regimens guarantee continued assistance and advancement in the handling of incontinence issues.

Though most cases of enuresis go away over time, sometimes treatment becomes necessary. The doctor will decide what will work best for your child after a discussion with you. It will also depend on the underlying cause if diagnosed.

The treatment options for your child's urinary incontinence include:

  • Lifestyle modifications like changes in fluid intake, reducing the intake of caffeine, etc.

  • Moisture alarms: These are battery-operated devices that use a sensor to detect wetness and raise an alarm when your child begins to pass urine, making him get up and use the bathroom. If the child is a deep sleeper, you can listen to the alarm and wake up the child. It is a better long-term solution, but it will take time to show results.

  • Bladder training: Exercises as advised by the doctor can be used to train the bladder, and urinating on a schedule helps too. 

  • Medications: The doctor may prescribe certain medications if necessary and if other methods fail. Medications can be given for boosting ADH levels, calming the bladder muscle, etc.

  • Counselling and education: A counsellor can help your child cope with these changes or other stress.

Collaborating closely with medical professionals guarantees personalised treatment plans that effectively address childhood incontinence problems. Children with bladder disorders can be effectively managed with the following strategies:

  • Analyse the issue: Determine the root cause of the issue, whether it is due to an overactive bladder, constipation, or another underlying problem.

  • High-fibre diet: To help promote regular bowel movements, increase your diet of fruits, vegetables, and whole grains.

  • Scheduled voiding: To retrain bladder muscles and lower the number of accidents, set up a restroom routine every two to four hours.

  • Medication: If dietary modifications are insufficient to control an overactive bladder, use drugs such as oxybutynin or mirabergon.

  • Exercises for the pelvic floor muscles: Perform "quick flicks" and "Kegel exercises" to bolster the muscles supporting the pelvic floor and enhance bladder control.

  • Biofeedback therapy: Through specialised therapy sessions, acquire skills for controlling your muscles.

  • Medical interventions: Use topical therapies or weight control to address particular issues, such as labial adhesions.

With certain lifestyle changes, this condition can be managed. These include:

  • Avoid drinking or eating foods with caffeine, especially in the evening or night.

  • Limit the intake of fluids in the evening and encourage drinking more liquids in the morning or early afternoon.

  • Urge the child to pass urine after every 2-3 hours or so.

  • Urge double voiding before bed.

When parents bring their child to a Paediatric Incontinence Clinic, they may anticipate a thorough assessment of their child's problems with bladder and bowel control. This usually entails a thorough discussion of the patient's medical history, an evaluation of the symptoms they are currently experiencing and how they are affecting their day-to-day activities, and a physical examination with an emphasis on gastrointestinal and urinary system health. In addition to discussing potential causes of incontinence and creating a customised management plan based on the child's needs, the healthcare team will offer advice on behavioural techniques, lifestyle changes, and appropriate treatments to enhance continence.
 

Looking at your child’s symptoms and issues, your paediatrician may refer you to a paediatric urologist or paediatric nephrologist. Prepare yourself and your child for your first consultation at the Child Incontinence Clinic to get the most out of your visit. The preparation includes:

  • Note down any key personal information, like any major stress, recent life changes or any event.

  • Check the family history of siblings and parents.

  • Make a list of all the medicines, herbs, supplements or vitamins that your child is taking and their doses.

  • Note down any symptoms you see in your child related to or not related to wetting. Child’s bathroom visit and fluid intake, etc.

  • Questions you want to ask but may forget during that time, such as what is causing wetting? What treatments are available? How can you help your child? etc.

The purpose of these practices is to reduce stress and shame, creating a positive atmosphere to help overcome bedwetting difficulties. Listed below are some tactics to assist children who struggle with bedwetting problems.

  • Fluid management: To minimise the discharge of urine at night, encourage consuming fluids early in the day

  • Regular bathroom visits: Make sure your child uses the restroom twice before bedtime to empty their bladder and every two to three hours during the day

  • Avoid irritating drinks: Sports drinks, citrus juices, and caffeine can irritate the bladder and cause increased urination. Limit these beverages

  • Encouragement: Provide clothing that is simple to take off in case of mishaps during the day, and think about getting a discreet wristwatch alarm for reminders

  • Tips for before bed: Make use of waterproof bedding layers and let your children help clean up without being too strict

  • Promote hygiene: To control urine odour and increase your child's self-esteem, make sure they take baths regularly and follow hygiene

  • Positive approach: Reassure your child that bedwetting is a common occurrence and that together, you can find ways to manage it that will empower them with a sense of control

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