New here, my daughter has bladder problems

[helenL18]

She is 6.5 yrs and has been wetting her pants everyday since being potty trained - although she was dry for first few weeks of school! - I remember her teacher telling me she goes to the toilet a lot. Since then got worse, in introduced mini tena pads and she wets passed these now. She has been to Dr and prescribed movilcol but I don't think this is the issue here. Just want some reassurance I am not the only parent, and hoping she will grow out of it!?

[JoPit]

Hi Helen

My little girl is 5 and although doesn’t suffer with bladder issues she does suffer constipation. She has been on movicol for a few weeks which has helped but I’m not sure how this will help the bladder. We recently purchased a family toilet seat which has the child seat incorporated in it and it’s been very well received as she feels safe and grown up. It’s so frustrating not understanding the cause and dealing with a child who suffers like ours do, you aren’t alone in this and I really hope your little one gets the help she needs. Have you tried restricting drinks to set times ?

[helenL18 in reply to JoPit]

Hi Jo,

Thank you for your reply! It is so comforting to have this contact with people like yourselves. It's good that your daughter feels better with the toilet seat must be scary worrying about falling in bless her! I have decided to go back to the Dr to discuss further. I do keep a close eye on her drinks, and reduce after tea, but as she is still in nappies at night it doesn't bother me so much its the day wetting that I am more concerned about at the mo. She doesn't drink all that much from the bottle she takes to school and only has a splash of milk with her breakfast and small sip of water - I know she has a small beaker at lunch though, but I don't want her to reduce her water intake to avoid constipation. I know she has regular bowel movements and no problem with straining or anything it is my gut instinct telling me something else is going on so I am taking her back to the Dr.

Hxx

[Nanoiu]

Hi Helen,

My son who is 5 and a half yrs old takes Movicol for chronic constipation with soiling. Is it possible your doctor suspects your daughter could be constipated? What explanation did your doctor give as to why your little one wets herself?

The urinary bladder is close to the rectum. If the rectum is enlarged from long term constipation and if one or both of these organs are full they can easily press on one another increasing the chance for accidental wetting.

A friend of mine has a daughter suffering from chronic constipation and in addition to the traumatic experience of soiling she also deals with a lot of wetting accidents, as well as UTIs (urinary infections).

Can you rule out that your daughter is constipated?

[helenL18 in reply to Nanoiu]

Hi

Thanks for your reply. I am pretty sure - although of course not 100% that she isn't constipated as she goes fairly regularly, changing occasionally in appearance from pebbly to loose stools. What is chronic constipation? is it not going for days and hurting? My daughter doesn't complain but maybe I am missing something. I will carry on with movicol but taking her back to Dr anyway - my friend is a nurse and advised she should have further tests from what I have told her. Her wetting is constant whether at home or school and I tried to take her pads away to start over but she doesn't want to and I don't want to nag her all the time!

One step at a time, maybe at the holidays I will make diary of her stools, give water only set times and very little perhaps.

Hxx

[AliStan]

You are definitely not alone. Worth searching around this site because there are a lot of really helpful stories on here that even if they don't give you answers, it may help give you questions to ask the professionals when you next see them.

I'm a bit confused by the movicol prescription, as this is for constipation yet you don't mention that at all. My daughter is now 8 and she was prescribed that originally by GP despite no evidence of constipation and unsurprisingly it made no difference whatsoever which leads me to think it's almost a default if they don't know what else to do. We now know my daughter has an overactive bladder at the root of her problems. I won't go into details as have covered before in other posts but the need to go to the toilet often can be a sign of that so happy to answer any questions you have. That said we are still battling on and so don't expect any magic solutions!

My biggest advice to you from what you've said would be to push to get some better answers. My greatest regret, knowing now that there is an underlying issue for my daughter, is that I believed the line "she'll just grow out of it" for too long even though in my gut I knew it didn't feel right. I feel I let her down. I didn't want to be that pushy parent and so wanted to believe that it would fix itself when actually I could and should have been getting her the help she needed earlier.

Best of luck.

x

[helenL18 in reply to AliStan]

Aww you know I feel guilty now also believing she will grow out of it! - How did you arrive with that diagnosis? I imagine that is what is happening with us possibly....as your daughter is now 8 I wanted to ask how this affects her? My daughter as yet doesn't seem bothered a lot but I'm guessing that will start to change - I just want to be able to support her as best I can.

Hex

[EHM39]

I echo all the advice here. Go back to your GP, question the medication she is on and try and get a referral to paediatrics at your local hospital. From there you can hopefully get referred to a continence clinic or similar. It isn’t easy and you have to push a lot to get answers and help and be patient. But so frustrating in the meantime! And like you said you worry what the future holds for your child. Final thing I would say is fluids are really important. Definitely don’t restrict her water intake during the day. I’ve been told to aim for 7-8 cups a day. Good luck! You are not alone AT ALL! X

[helenL18 in reply to EHM39]

Thank you!!! Kind, lovely people!! xx

[AliStan]

Sorry, I didn't mean to make you feel guilty but just wanted to give you courage to go with your gut. You know your daughter best and you'll do the right things for her. Getting to OAB diagnosis wasn't easy, we started with GP and until I broke down in front of a locum I was told not to worry she'd grow out of it. The locum (female!) refered us to peadiatrician at local hospital who first mentioned OAB and started her on Oxbutynin. She didn't give me any confidence in the diagnosis though and when she mentioned (in passing on telephone consult) a specialist children's bowel and bladder clinic in London, I jumped on it and she agreed to refer her. It was there (Evelina Hospital) that we finally got clear diagnosis and started treating. From first visit to GP on wetting issues through to first appointment at Evelina was probably 2 years plus and we've now been with them over a year, due back again next month.

In terms of my daughter, I'm lucky in that she is quite strong willed and confident. Since getting the formal diagnosis she's been "happy" to be open about it with friends as she can now say confidently it's a medical condition. We've only had one incident of name calling so far and she was more worried about her friend (who still wets at night) being upset than anything else. Sometimes I wish she would worry about it a little more to give her incentive to work harder at bladder control exercises but ultimately it's better that it doesn't seem to stress her. My worry is coping later this year on a 2 night school trip and then only another couple of years before senior school but we'll tackle that when we get there.

[helenL18 in reply to AliStan]

Wow you have really been through it bless you and your daughter. Glad she is ok with things, how great be open about it - especially with sleep overs and all that.

I decided to make private appointment its in the 3rd April as I am now on the case I don't think I have all the patience for waiting under the NHS...I have asked my Dr for a referral. Mind you this sounds like it can get quite expensive!

We shall see....xx

[EHM39 in reply to helenL18]

Well done on taking action! And I was really interested to read about the Evelina too. May look into that. Similar to Alistan, we just went to the hospital last month for the first time and waited since last August for an appointment. Felt like years! We were also rejected first time but I kept on going. I was a total wreck at the appt (just overwhelmed I think with the stres and relief of it all). I obviously don’t recommend this! But I think it did help them to take me v seriously. Good luck with the private appointment x

[Helen36]

Hello - you are definitely not alone. There is a whole sorry band of us on here dealing with this! So, where to start... my nearly 5 year old has also been diagnosed with an overactive bladder and the symptoms are very similar to you. It could be this, it could be an underlying UTI not picked up, it could be a ‘voiding’ issue (not emptying properly), a capacity issue or lots of other things - getting a paediatric urologist on the case is definitely the way forward. You GP could refer you to your local continence team as well but again, the waiting lists can be long.

Our overactive bladder was almost certainly caused by deep constipation and so we remain on movicol. Constipation can be hard to detect and the clinical pathway for treating day wetting will always start with treating for constipation. But unless you have actually been asked to do a disimpaction, a movicol prescription won’t actually rule this out for you, which is why a referral is good because they can help rule this out (and hopefully without having to do a clear out with masses of movicol!)- they might X-ray.

So in terms of what might help in the mean time, a few tips:

- get her drinking lots of water, around 1.5litres or more a day if you can manage it. Do this in regular drinks (breakfast, snack, lunch etc) rather than sipping alll day and get school to support this. If it is an OAB, lots of fluid helps calm the twitching and the predictability of drinks helps give the bladder consistency of filling fully and emptying fully. If you can stop squash and anything citrus you might notice a difference too. A bit of a process of elimination has helped us work out we need to stick to water, milk and apple juice. (Thanks to whoever it was on here that suggested cutting out orange squash - made a huge difference!!)

- start a pattern of when she goes to the loo to try for a wee. Again, it’s all about consistency. She’ll probably still wet around this, and with extra drinking it will get worse at first, but bladders are sensitive souls and giving it predicatability will help in the long run. Once you are on a solid drinks routine, you’ll probably be able to work out when that hits base and try to go before it leaks! We are c.22 minutes ...!

- after each wee, get her to get off the loo and have a little jiggle about and spin around. Not all bladders are perfect balloon shapes and can have little pockets that retain wee. A jiggle will help get this out and then having a second try also helps ensure she is emptying properly.

There is lots of other good advice on here. I think i’ve replied to most wetting posts going (!) so you can look at my posts to give you a good starting point to find some good threads.

But my sorry conclusion is that there are no easy fixes I’m afraid. Even those of us with referrals and medication haven’t found it plain sailing. Hope she’s coping with it OK, and you.

[Sarah01234]

Hi, my son used to wet himself every day. He got no warning for when he needed to wee. The doctor gave him laxatives and I was not convinced at all. At the time I couldn’t understand why she’d given them to him as I was sure he went to the toilet fairly regularly and didn’t seem constipated but we tried it, and it worked! His accidents became much less frequent before eventually stopping altogether. He still doesn’t get much warning but it is so much better than it was!

He doesn’t take them anymore but we’re much more aware of his diet now. If he has too much bread/carb, he can suddenly need to go more urgently again and although he doesn’t tend to have accidents anymore, we can notice the difference in his urgency!

Give it a go. Good luck!

[Littlecabbage]

Hello,

I’m not sure I have much new to add, except to give you further proof that you are not alone! My 6 year old son has always had problems with regular daytime wetting, urgency and uncontrollable leaks. He has finally been diagnosed with “dysfunctional voiding” which means his bladder does not fully empty when he passes urine, due to his pelvic floor/urethral pshincter muscles not relaxing as much as they should dyring bladder emptying. See my own posts if you want a full rundown!

Just to echo the points made by others:

1) Definitely do not restrict water. Encourage drinking as much as possible, even if it seems counterintuitive. The bladder wall is a big muscle, and needs to be exercised by regularly filling as full as possible, then completely emptying. This alone will not solve the problems, and may initially make it seem worse, but is very important.

2) Push for referral to a paediatric urologist. Like you, we followed the “he will grow out of it” nonsense, even though we knew something wasn’t right, and it wasn’t until we saw a paediatric urologist at our local children’s hospital last year, that we began to get proper investigations and answers. In your case, it sounds like they need to confirm whether constipation is an issue, or whether t is something else.

Also, I noticed you are having problems with mini pads becoming saturated. If it helps, we use Tena Lady Extra Plus pads (designed for adults). My son wears one to school in the morning, and changes it just before lunch. Then changes again at around 4pm at home. He wears a size 6+ nappy at night.

Hope that helps.

[Meravigliosapaura]

Hi Helenam how are things going for you now?