Smaller bladder capacity - Pediatric Oncall

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Question :

My daughter has completed 7 years. She is facing problem of bedwetting. Primary checking of urinary track is done in Singapore. There is no problem. How ever the treatment suggested by the doctor ( as he told us) contains medicine which will reduce production of urine at night. But we should not continue the same for longer time. I don't know the truth. He suggested to use BED WETTING ALARM. Since we are planning to shift to India, I would appreciate your advice in following matter. 1. Is such alarm useful? 2. Is it available in India? 3. What treatment will you suggest? I will be obliged, if you kindly advice me. Yours faithfully,

Answer

Since your child's urinary tract problem has been ruled out, the basic problem in your child is a small bladder capacity. As a result when the urine accumulates in the bladder upto its capacity, it automatically voids. During day time the patient is aware of the sensation that she wants to pass urine and hence there is no wetting in the day. However, in the night, she may void. The treatment consists of trying to increase her bladder capacity. This consists of various things. One could be to avoid any fluids 2 hours before she goes to bed. Just before she goes to bed, ask her to go and pass urine. Also, during the daytime, whenever she wants to pass urine, ask her to hold on for as long as she can. If she can hold on for more than 10 -30 minutes at a time, reward her so that she gets an incentive to try harder. Also, reward her for a wet free night so that she gets the incentive. Sometimes waking her up in the middle of the night to pass urine would also help. If after all these manouvres, she still bed wets, the alarm can be tried. This is an electronic device which sends of an alarm when the bed becomes wet. This wakes up the child and since this stimulus is not pleasing, it conditions the child not to pass urine in the bed. This alarm is not routinely available in India. Finally, drugs such as Imipramine and Desmopressin can be given, however, they are not curative, only controlling. Training your child is what will be the permanent solution.


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