8-year-old Amanda* regularly wets the bed once or twice per week, as well as suffering from constipation and difficulty falling asleep at night.
Amanda’s night-time incontinence results in her waking up fully soaked, with urine overflowing from her nappy onto her clothes and bed. While she can sometimes go nearly a month without wetting the bed, she returns to weekly or twice weekly occurrences.
During the day, Amanda’s bladder frequency is normal and she is continent. Her fluid intake is around 1 litre per day and she is an active, social child, engaging in swimming, soccer and gymnastics.
Amanda has to strain when passing bowel movements and, while the process isn’t painful, it is difficult and uncomfortable.
With the help of Sydney Pelvic Clinic, Amanda and her parents hope she can overcome her nighttime bed-wetting, as well as relieve her difficulties passing bowel movements.
Making bedwetting a thing of the past
As part of her assessment, Amanda underwent a physical examination, as well as an ultrasound of her bladder, resulting in a provisional diagnosis of nocturnal enuresis with constipation.
The physio developed a treatment plan for Amanda, involving a combination of constipation management and night-time bedwetting treatment. The treatment plan would be reviewed regularly in order to adjust treatments based on the outcomes.
Amanda’s treatment plan included:
- The use of psyllium husk and Osmolax Junior to improve stool consistency
- Increasing fluid intake during the day to 1.6 litres, spread out more evenly throughout the day
- A bed-wetting chart to monitor her progress
- Sleep management, including a night-time stretch routine and a bedtime worry journal
- Bedwetting alarm therapy, with education and instructions provided
What were the outcomes of Amanda’s treatment?
After two weeks, Amanda was experiencing less straining on the toilet and though her night-time wetting was still present, the volume had reduced and no longer overflowed from the nappy.
After a further two weeks, Amanda was finding it easier to fall asleep at night and appeared more refreshed in the morning. Her bedwetting remained at a similar level – however, her parents acknowledged that the treatment routine hadn’t always been maintained and they were aiming to stick to it more closely going forward.
Four weeks later – and after the introduction of the bedwetting alarm – Amanda had been almost 100% dry for a full month, experiencing just one accident in this time.
When we followed up a few months later, Amanda’s bedwetting had completely ceased and she’d discontinued the alarm therapy. A great outcome for Amanda and her family!
*In the interest of patient confidentiality, names have been changed