Bladder incontinence in a 10 year old?

[purpleplum]

My 10 year-old DS has always had bladder issues. When his bladder is full he either doesn't notice, or doesn't want to stop what he's doing to visit the loo, until it starts to leak out. Consequently he often has a wet patch.

It's got better over time, but sometimes worsens when we're out of routine, such as on holiday.

I took him to the GP about this when he was about 7. They said there wasn't anything physically wrong, and it was just a psychological thing he would grow out of.

There's definitely a psychological element to it, because there's a correlation with when he's distracted by something exciting and doesn't want to stop. He often denies needing to go, even when he's jiggling around uncomfortably. However, I can't help wondering if there's an underlying physical issue that might be desensitizing him, because sometimes I have to point to his wet patch to prove to him that he needs to go.

Strangely, he doesn't seem to get teased about it. Boys being boys, his friends don't tend to notice, and if they do it doesn't bother him - he just makes up some implausible excuse about spilling his water bottle, or falling in a puddle, and brushes it off.

He's completely dry at night, and has been since he was 5.

So, should I carry on waiting for him to grow out of it? Or ask for a referral to a specialist?

(I did once read a book about bladder issues by a US specialist, who advocated surgical intervention for children's leaky bladders, but he seemed to be mostly dealing with night time bed-wetters, and the procedure sounded pretty unpleasant).

Yes do ask GP for a referral to a continence clinic (horrid name)

It sounds like he has never been dry in the daytime; nighttime dryness is a different matter, being hormone-driven most of the time.

My advice for now would be - increase fluid intake through the day, might need to get school/teacher onside. Thrust a sports bottle of water at him every day as you walk from the school at pickup time (or get the relevant adult to). You are aiming to stretch bladder by increasing fluids, this should give greater holding capacity.

Sorry can't be more helpful

I'm quite surprised by your GP's reaction. we had similar with ds and while it certainly started out as behavioural, the thing is this can then lead to a physical issue. good news is it can be fixed given time and patience. Have a look at the ERIC website for advice - really good.

There are social reasons why you need to tackle now, currently his cohort are accepting but groups out of school - scouts, etc - might not be x

Are his bowels ok? Being constipated affects the peeing too.

I would definitely press for further action. The school nurse may be able to help you sort something out or refer him to the continence service.

In addition to the good advice above, I would enforce regular (2 hourly) toilet trips to 'try, even if you don't need to go'.

Thanks everyone. That's helpful.

I do struggle to get him to drink enough water, and I think he does sometimes get a bit constipated as a result. I've recently had some success encouraging him to notice when he's dehydrated and do something about it, but, as with the toileting, he's a reactive thirst-quencher rather than a strategic one.

I will plan to take him back to the GP. Last time I asked DS whether he wanted to see a male rather than a female GP, and he said male. However, I think the female GPs at the surgery are better, so maybe I'll try one of them instead.

Sounds to me like it's time to go back. I'm surprised your GP was so dismissive. With DD (7) I found the school nurses really helpful, though it's a bit weird that it's all over the phone these days, and they referred her on to enuresis clinic. Daytime wetness is something that needs sorting, and I imagine doing it before senior school is prob important.

Absolutely right that there is very often a link with constipation but I think you'd do better to get him seen and then you can tackle it in a structured way and get to the, erm, bottom of it rather than just trying different things and hoping something helps.

I'd echo that www.eric.org.uk is good. They are also on FB.