Table of Contents Urinary Incontinence & Bed-Wetting How Does the Urinary System Work? What Causes Nighttime Incontinence? What Causes Daytime Incontinence? What Treats or Cures Incontinence? Points to Remember Keeping on Top of Your Condition Additional Resources

What Treats or Cures Incontinence?

Growth and Development

Most urinary incontinence fades away naturally. 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.

• Bladder capacity increases.
  
  
• Natural body alarms become activated.
  
  
• An overactive bladder settles down.
  
  
• Production of ADH becomes normal.
  
  
• The child learns to respond to the body's signal that it is time to void.
  
  
• Stressful events or periods pass.
  
  

Medications

Nighttime incontinence may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin, or DDAVP, which recently became available in pill form. Patients can also spray a mist containing desmopressin into their nostrils. Desmopressin is approved for use by children.

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 or other foods or drinks that you suspect may contribute to your child's incontinence
• following suggestions for healthy urination, such as relaxing muscles and taking your time

Moisture Alarms

At night, moisture alarms can awaken 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.