Incontinence

When we think about Incontinence, this is really day time wetting. This can be awfully embarrassing for the child, these accidents occur in school, on their way home from school or even on the way out of the cinema. This can also be a really stressful time for the parents who have frequently gone to many medical practitioners and they feel very concerned and worried that little or no progress is being made.

Here at London Children Surgery, our focus is ensuring your child has the absolute best chance of becoming dry in the day time. We have a well proven track record of investigating and explaining the causes of your child’s accidents. Your child will fully understand what’s going on and be able to help themselves get better. The vast majority of children require little medication. If medication is required, it will be the right medication for your child and given at an appropriate dose. At the end of the day we have a motto that states we want for every child to be happy, healthy and dry. We strive for that and haven’t failed yet.

What is Incontinence?

Incontinence is the accidental or involuntary loss of urine from the bladder. Most children have developed incontinence in the day time by the age of 4. If the control of the bladder is problematic during the day, this is called day time incontinence. If this occurs at night time this is called nocturnal enuresis or bedwetting. Lost of children have a combination of both.

In reality there are two major type of day time incontinence. The first is primary, where the child has never been able to become properly dry in the day time and from the moment of toilet training onwards they have always had accidents.

The second type of incontinence is called secondary. This occurs when a child has developed continence in the day time and the night time and is dry. At some stage, for some reason, they then develop day time incontinence and start to have accidents in the day time.

In both situation the children should be investigated and supported through this difficult time.

Most children grow out of these accidents and do not require treatment. Day time incontinence is not caused by behavioural difficulties or failure of toilet training or your child being lazy. There are usually real causes to what’s going on which can be quite detrimental to your child’s wellbeing and it is very important to resolve this. The vast majority of wetting in the day time occurs because the bladder is not working properly.

What types of incontinence are there?

In reality there are two major type of day time incontinence. The first is primary, where the child has never been able to become properly dry in the day time and from the moment of toilet training onwards they have always had accidents.

The second type of incontinence is called secondary. This occurs when a child has developed continence in the day time and the night time and is dry. At some stage, for some reason, they then develop day time incontinence and start to have accidents in the day time.

In both situation the children should be investigated and supported through this difficult time.

Most children grow out of these accidents and do not require treatment. Day time incontinence is not caused by behavioural difficulties or failure of toilet training or your child being lazy. There are usually real causes to what’s going on which can be quite detrimental to your child’s wellbeing and it is very important to resolve this. The vast majority of wetting in the day time occurs because the bladder is not working properly.

How does wetting occur?

Wetting occurs in the child in the day time due to a failure of communication between the bladder and the spinal cord (which sends information from the bladder and the brain). If there is a breakdown in one part of this area, day time wetting will occur. Very frequently there is a combination of factors that have combined over time to cause the wetting to worsen. All these need to be dealt with and resolved in order to a happy, well and dry child.

What happens when we come to see you to help with my child’s incontinence?

Firstly we will take a very detailed medical history to get a clear understanding of what’s going on and hat are the likely causes of this incontinence. We will examine your child to ensure there is no obvious pathology, and we frequently arrange an ultrasound scan to ensure there is no anatomical problems. The situation will be explained in great depth and your child will get an understanding of what is required and what the plan will be. A bladder diary homework is set and a noninvasive bladder test is performed at the time of the next review in order to ensure your child is emptying their bladder and voiding as well as possible. With all this information we can help make great progress getting your child well.

How long will it take for my child to get better?

This depends on your child’s underlined diagnosis and their engagement in the process. Most children when they truly engage with wanting to get dry can make great progress. Another reason it can take awhile for some children to get better, there can be delays in seeing the appropriate medical help or they have been seen by other doctors or professionals and have not been successful. When this occurs, frequently we don’t get the progress we would like to see. This is well recognised, but we work with the child in order to ensure that we can resolve these problems for them and move them forward.

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Mr. Feilim Murphy

MB, BCH, BAO, FRCSI (Paeds)
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Mr. Bruce Okoye

MBBS, FRCS (Paed), MD
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