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Management programs come in a number of
stages:
Undertaken by Paediatrician and Continence
Nurse Advisers. Most information is gained from the history of the problem.
Initial Assessment
» History of Problem
The interview explores areas of:
- - Family structure and history of wetting or
bowel problems.
- Past illnesses.
- Defining the patterns of urine flow, bowel problems/soiling.
- Any associated problems.
- Any previous efforts to manage the problem and their success/failures.
- Motivation of the child to be involved.
»
Examination
The examination is undertaken by the paediatrician. It is required to help rule
out underlying disorders, which are most uncommon for bedwetting. A possible
association with constipation is also investigated.
» Patterns of Urine Flow / Bowel Passage.
The "voiding" pattern both day and night needs is assessed.
Pattern of stooling and/or soiling is charted.
Follow-up
Visits |
- Fortnightly with Paediatrician / Continence Nurse
Adviser. |
Telephone |
- Frequent, between clinic reviews. |
Mail |
- At least weekly (e-mail and snail) |
It can not be stressed enough that the success of
any management plan is highly dependant upon
- - Active
participation and responsibility by your child.
- Positive
encouragement and involvement of parents and family.
- Close
supervision and contact with therapists.
- Focusing on
gains
- Evaluation and encouragement of progress
Plan
A family centred plan will be discussed and negotiated
with you and your child. An active encouragement program for your child will be
implemented. Encouragement is paramount for your child (and yourself).
» The plans can
include:
Nocturnal
Enuresis & Daytime Wetting |
Soiling /
Encopresis |
- General Measures - Fluids / Sleep Routines
- Reward & Encouragement Programs
- Bladder Training Programs
- Bed Wetting Alarms
- Medication* |
- General Measures - Diet / Fluids / Routines
- Reward & Encouragement Programs
- Toileting Routines
- Stool Softeners / Laxatives
- Behavioural Therapy |
*Medication is rarely used.
Wetting usually starts after it's cessation. Best used
for over night stays, school camps |
For most bedwetting, the enuresis alarms are
-" The Treatment of Choice "
BEDWETTING ALARMS
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Last Updated Sunday, 01. May 2016 |