End of my tether with 7 year old wetting himself

[Wellhellothere1]

Hi. I'm hoping someone can help with some advice on how I can deal with this. My 7 year old DS has had a problem with wetting himself for years and I just don't know what to do now. He goes for weeks and months with no accidents at all but then he goes through phases of wetting himself on a daily basis (sometimes multiple times) and this lasts for a few weeks. This current phase has lasted now for about 4 weeks and I could cry with frustration. My parental instincts tell me it's not a medical issue as it doesn't happen all the time. I think it's behavioural-he's having too good a time to stop what he's doing and go to the toilet.
I've tried everything to deal with this-
Saying nothing and quietly help him get changed. Didn't work
Giving him an incentive to stay dry-play date/day trip with friends. Didn't work
Make him put his clothes in the washing machine and go upstairs to get changed. Doesn't work
I called the ERIC helpline and they were a great help and advised me to help him increase his fluid intake. Doesn't work.
I've dipped his urine and there's no infection. He's usually dry in bed and only has a couple of accidents a year.
Tonight when he came home from school his pants were soaking wet, he smelled of urine and he has a rash in between his legs.
I said tonight he had a few days to try and help himself. If he doesn't he will be grounded which is his worst fear! I've never grounded him before but I can't believe he's 7 and still regularly wetting himself so I feel I need to try something drastic. I don't want him to be picked on at school because of this. Plus I need to turn down playdates after school as I don't know if he'll be wet or dry when his friends' mums pick him up. Has anyone else gone through this and have any words of wisdom?

Oh, poor boy. The teacher situation isn't ideal, we were definitely fortunate in that regard.
My DS is like yours, in that it starts and stops... and I think it took us a long time to link it to constipation issue. I do try and keep on top of that- lots of fluids (he only drinks water, so at least I know it's doing good) and fruit when he will (he's v restricted food-wise unfortunately, which does lead to constipation).

That is tricky. DD was happy to wear it (and still wears it happily at night) but you're right, if he's got his mind set against it then it probably would be counter-productive. It's awful when it turns into a head-on battle between you and DC (I had that situation with DD when she was 3 or 4 because she just would NOT go to the toilet, which probably worsened things).

There is an advert I've seen for Dr Jacob Sagie - an Israeli doctor who has an online bedwetting treatment. It seems to get very good results and have lots of good reviews, and be set up so that it can be tailored to your child's particular situation. I had that earmarked as the next thing to try if DD still wasn't responding by Christmas. You might want to take a look at that?

The constipation thing is definitely a root cause for DD. I never thought she was constipated, but with hindsight it was a big part of things.

She has been on a long, long course of Movicol (one sachet a day for about 2 years!) Each time I tried to reduce it, the daytime-wetting got worse. However, we've just had another try and are down to not taking it at all, and everything seems fine, so perhaps she doesn't need it any more. But if wetting starts up again then we'll go back on it. The paed urologist said it was much better to keep taking a low dose (which one sachet a day is, apparently) than to have constipation issues,)

I've also found that for DD having any sort of cold/cough/fighting off a virus seems to worsen wetting problems. I think it somehow dulls the sensation of needing a wee and also changes the body's fluid needs.

Sorry to keep posting, but this has been such an enormous issue for us, that I really feel for you, I know how desperate I've felt about it at times

I echo strange's last paragraph!! It's very hard, because you don't want them isolated because of it, but they don't want to go when you prompt them.

I really don't know if this would help at all, it's just an idea, but during the day could he have a watch that has an alarm on it, set it for every two hours or so, and when it rings he has to go to the loo?

DS had very tight foreskin and issues with going to the loo very often and he had to have a circumcision as he had regular infections, it might be worth going back to the GP and ask to see a urologist?

I would also try and have a schedule - drink at breakfast (loo one hour later); drink at 10 (loo at 11) etc. Not just sip of water throughout the day. Would your school be keen on working with you on that?

Thank you both so much. As most parents do I blame myself and feel I maybe haven't handled wetting incidents well in the past and I've psychologically damaged him so much that it's now an issue! We see the GP next Friday and I'll definitely speak to him about the possibility of constipation. I'm sure he'll agree that a trial of Movicol can't do any harm. And I don't think I'll speak to the school just yet. My DH had an embarrassing issue when he was at around 7 and he had to be excused from class to see the school nurse regularly and when his classmates found out about it he was bullied relentlessly until he left secondary school. It makes me feel awful for him hearing about it. He's adamant that we shouldn't speak to the school in case the same happens to DS. Kids can be so cruel can't they?

Sorry two I didn't see your post there. Thanks for your reply. The tight foreskin thing may be an issue-my DH had him at the GP for this a couple of months ago and the GP thought it was fine so no treatment needed but perhaps it's all linked somehow. I'll discuss it again next week with the GP.
Wrt to drinks on a schedule. In theory I get it and it sounds so simple but he isn't a kid that likes to drink (he loves his food-he'll eat anything) so again it turns into a battle to try and get him to drink fluids and increases the stress accompanying all of this. We start off full of enthusiasm and reward charts for drinking but this enthusiasm wears off when I'm constantly trying to pour liquid down his throat! He could go for days without drinking any fluids at all. When his pals come to the house they constantly ask for drinks so I know he's unusual in that respect. I'm just tired of it all now. It's been going on for years!

The urologist we saw said that part of the problem is that young children have very malleable brains - i.e. they are built to learn new behaviour patterns. So if something puts them off going to the loo (like pain from constipation / balanitis / UTIs - and perhaps also tight foreskin issues?), then they quickly adapt to 'avoiding going to the loo in order to avoid pain' and this behaviour becomes very self-reinforcing (because they can avoid it so long that they get used to ignoring the signals). He said it's very easy for children to learn a pattern of ignoring the bladder's signals to the brain so that they genuinely are unaware of it. This was definitely DDs situation - her body knew she needed a wee (I would see her hopping about doing the 'wee' dance), but her brain just wasn't picking it up! It wasn't just stubbornness (although I think she was stubborn too!)

Don't blame yourself. I did too, but had to remind myself that I have 3 kids, and only one of them had this problem, so I think it's a combination of circumstances that leads to a negative cycle that affects both body/physiology and brain/behaviour.

Also, I understand your DH's point of view, and totally agree that children can be little brutes. But not telling school anything can aggravate the problem. The kids will notice if your DS is wet/smells. It would be better if he has some way to manage it when it happens. My DD had a particular TA who would watch out for her, and find an excuse to take her aside & out to a staff loo where she could get changed. I also made sure that there were two complete sets of clean uniform in her PE bag at all times, always in the same place/bag so the TA could grab them quickly.

strange bloody hell that's so interesting! The info the urologist discussed with you makes compete sense. It looks like we have a long road ahead of us. Thanks for all of your support. X

Hi all. In case anyone was interested I took my DS to the GP yesterday. He doesn't have a UTI or sugar in his urine. The GP had referred him to our local hospital's enuresis clinic. He's a bit stumped as to why the wetting comes and goes and he's mostly dry at night but perhaps the clinic has more experience. Thanks again everyone.

Again thought I would update in case other parents are ever looking for advice in the future with similar problems (I have found MN to be the most useful source of advice) After the GP appointment I kind of broke down a bit at night with my DH and said how awful I felt about DS and how I was really worried about this. He came up with the idea of doing a water challenge with DS and from the Monday morning we challenged both DS and DH to drink 3 large cups of water per day. Each day the person who drank the most would get £1 and the challenge would last until Christmas. I figured this would be cheaper than a private paediatric urologist! We didn't mention any links with improving wetting accidents at all to DS so he was hyped about it and really wanted to win. His water intake went through the roof and the difference has been miraculous. After a few days of inevitable wetting accidents he really improved. He started having to run to the loo for a wee instead of us telling him to go-he's never done that reliably. He has been dry day and night now since we started and has kept up with the water at every meal and snack. I think this has made the difference as we haven't mentioned water helping with wees and it has appealed to his competitive side by trying to 'beat' dad drinking water. He is also so much happier that he isn't having accidents. I hope we can keep up with regular water and I think we will as it's become a habit now.
It's still early days but the difference has been amazing and within a few weeks I feel his bladder has become much stronger and the wee signals much stronger too.
Thanks again everyone and Happy New Year!