Bladder training help!

[HelenaH]

My 8 year old son was diagnosed with overactive bladder last year. He has frequent daytime wetting and has never had a dry night, needs bed pants changing during the night or else we have wet beds. He reacted to medication so we've been told to try bladder training to try and improve the daytime wetting but given next to no advice on what to do. I've just been told to try and stretch out the gaps between going to the loo and make him wait 5 minutes when he needs to go. I'm not entirely sure how to make this work, he invariably wets if he waits and there is no chance of stretching out the gaps between loo trip because we'd get the same result! Just don't know what to doing. It really starting to affect our lives. Has anyone had success with bladder training or more comprehensive advice on how to actually do this? Be so grateful for any advice, have struggled on our own with this problem for years and don't know anyone else who has faced it.

[Hjmilward]

My daughter was also diagnosed with an overactive bladder which was meaning urgency in the day and bed wetting at night. In conjunction with taking oxybutynin, she also had to do bladder training to try and improve how much her bladder could hold. For us, the advice the bladder clinic nurse gave us was to increase the amount of water (and water only - we found juice and squash really aggravated her bladder) she was drinking throughout the day. This meant 250mls before school, a 750ml water bottle at school (they advised to mark lines on the bottle to ensure she drank a certain amount by break time, lunchtime and hometime - this worked!) and then atleast another 250mls by the end of dinner. No water atleast an hour and a half before bed (she had always been really thirsty at bedtime but drinking so much in the day helped with this). Obviously, at first all the extra water does increase the urgency but persevere and over time it has really helped. It increased the amount her bladder could hold from 60ml to nearly 200ml. What medication was your son prescribed? The oxybutynin definitely contributed to the success of the bladder training because it calmed down the irritation of the bladder. I wonder if there is alternative medication you can try? Hope this helps.

[MrsSquirrel]

Have you asked about Tolterindine? Oxybutynin didn't seem to work for us so we have been prescribed this. Other possible treatments include TENS and botox, and apparently (if you want to look at alternative to mainstream) acupuncture.

This is only anecdotal (family history) so you may want to research and look at who is reputable. nhs.uk/conditions/Acupuncture/ has a link to vetted practitioners.

We are same as you, 9 year old with probable overactive and small for age bladder.

Keep a detailed diary on weekends and after a month or two request another meeting to discuss if not working. Is there a continence nurse service within local NHS you can talk to?

We have found them v helpful.

[Longhaul]

My 10 yo daughter is in the same position . Oxybutynin helped but turned her into a monster! Tolterodine gave side effects but no improvement. We’ve been told there is no other medication as they work in same way. Our liaison person is now referring to physio to try some pelvic floor strengthening and also told to try Pilates as core strength helps. I’ve asked them to look into TENS as not something offered or known about here ( Edinburgh ) . I’m now at point of trying more complementary options as need her to be able to have more freedom . Night time can wait as it’s daytime that’s interfering. Hope you can find some solutions and I’ll share any I find!

[Helen36]

Hello - as a fellow parent with an overactive bladder I find the advice you’ve been given awful. Waiting to go? If only that was possible! My washing pile would halve in size for just 5 minutes!! The advice from other parents above is all really good. There are a range of dietary irritants to the bladder and blackcurrant and caffeine are really common ones but I find any kind of juice from concentrate results in an accident (my daughter is nearly 6) and others on here have said hot choc too. Getting volume of water through him will really help, preferably at regular intervals so the bladder fills and empties in a strong pattern. We’ve been able to use oxybutynin but certainly in the South east, there are other options other than tolterderine available where those react so I would push for more options.

One thing I wanted to ask is whether you have had it reviewed as to whether there is any constipation going on. This is a really common underlying cause of OB - as the bowel can press on the bladder if overloaded and cause it to twitch, which weakens the muscle at the top of the urethra... It’s so common this should be the first point of treatment for daytime wetting in a child - whether there are symptoms of constipation or not. This past point is really important as a child can be doing a nice big soft poo every day but have a massively loaded bowel further up. Are you under a consultant or continence team? I’m sure this has been looked at for you but worth flagging just in case.

Good luck and hope things improve for your son too x

[Mumof3L]

Hi all

Just been reading your posts as I'm really struggling here with my 9 year old son who has an overactive bladder.

Similar to Longhaul we experienced bad side effects from oxybutinin in the form of really aggressive behaviour. We finally got a consultant appt and she prescribed tolteridene...so far not seeing might improvement and I'm worried I can see some of the aggressive behaviour coming back

I'm feeling really worried as he goes on a 2 night residential school trip next week and I'd really hoped we'd be in a better position by now. I'm going to be stressed out the whole time he's there worrying about him wetting the bed and people being mean about it

We have also done 6 months with the bed wetting alarm and tried desmopressin before that.

Any advice?! Thanks so much x

[HelenaH]

Thanks for all the advice, am going to go to his next appointment better armed to get the best for him! He's currently just under a continence team I think, but I don't really know and have no way of getting in touch between appointment and no idea when we'll next be seen, doesn't seem to be that regular. A friend has been encouraging me to push for a referral to the Evelina (we're in London) as I've not been happy with the treatment so far. We haven't ever had constipation looked into as it's never seemed to be a problem, but something else to ask I guess. We're also very strict at home on drinks, only water and milk. Am going to try regular small drinks through the day, we had one good day doing this just after I originally posted then he got tonsillitis so everything went out of the window! It's so encouraging to know we're not the only ones going through this! Thanks so much to everyone who has replied.