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Many
children overcome incontinence naturally (without treatment) as they grow
older. The number of cases of incontinence goes down by 15 percent for each
year after the age of 5.
Medications
Nighttime incontinence may be treated by increasing ADH levels.
The hormone can be boosted by a synthetic version known as desmopressin,
or DDAVP. Users, including children, spray a mist containing desmopressin
into their nostrils, where the drug enters the bloodstream. Researchers
are developing a pill version of this drug.
Another medication, called imipramine, is also used to treat sleepwetting.
It acts on both the brain and the urinary bladder. Unfortunately, total
dryness with either of the medications available is achieved in only about
20 percent of patients.
If a young person experiences incontinence resulting from an overactive
bladder, a doctor might prescribe a medicine that helps to calm the bladder
muscle. This medicine controls muscle spasms and belongs to a class of
medications called anticholinergics.
Bladder Training and Related Strategies
Bladder training consists of exercises for strengthening and coordinating
muscles of the bladder and urethra, and may help the control of urination.
These techniques teach the child to anticipate the need to urinate and
prevent urination when away from a toilet. Techniques that may help nighttime
incontinence include
- Determining bladder
capacity
- Stretching the
bladder (delaying urinating)
- Drinking less fluid
before sleeping
- Developing routines
for waking up
Unfortunately, none
of the above has demonstrated proven success.
Techniques that may
help daytime incontinence include:
- Urinating on a
schedule, such as every 2 hours (this is called timed voiding)
- Avoiding caffeine
and the artificial sweetener aspartame
- Following suggestions
for healthy urination, such as relaxing muscles and taking your time
Moisture
Alarms
At night, moisture alarms can wake a person
when he or she begins to urinate. These devices include a water-sensitive
pad worn in pajamas, a wire connecting to a battery driven control, and
an alarm that sounds when moisture is first detected. For the alarm to
be effective, the child must awaken or be awakened as soon as the alarm
goes off. This may require having another person sleep in the same room
to awaken the bedwetter.
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