7 year old day time wetting

[EL8811]

I’m at my wits end. My 7 year old son still regularly wets himself. We are under bladder and bowl clinic and he takes movicol, oxybutynin and desmopressen but still no relief. Rewards don’t work either. He can have 5 wet accidents a day but isn’t bothered about wet clothes at all. Still wet at night too but this side I’m not too bothered with as yet. Anyone got any advice or success stories to give me some hope? I’m just exhausted.

Is this maintainance dose of movicol or he’s had a disimpaction regime? If he is impacted and that’s causing the wetting, which sounds likely, a maintenance dose will do nothing. Movicol mummies facebook group is good.

Other countries give abdominal x rays to determine if there is impaction, but this is hard to get in the UK on NHS, but not impossible.

Any signs of sensory processing issues? He could be lacking proprioceptive input and thus can’t feel when he needs to go.

Rewards only serve to make a child feel punished and ashamed for something they have no control over :(

Well we were referred to Occupational Therapy for potential dyspraxia last year. He is on 1 sachet of movicol a day. I’ve raised concerns with school and they have suggested potential sensory issues and have agreed to put in a referral to CAHMs.

we had years of febrile seizures which was down to tonsillitis which he hasn’t had any in over a year since having them removed.

If he has dyspraxia this is often seen alongside ASD. People with ASD quite often have CMPA, has he ever had an elimination diet for milk?

See I’ve said for so long he has ASD and ADHD traits. Finally got school to put in a referral to CAHMs which is a start. But no never had an elimination diet for milk. I’d never seen this link before to be fair. He has come home today wet, his response was he was too busy to go to the toilet but school have given him free access to go. He hates being dirty but the sensation of being wet doesn’t bother him at all. It’s just so frustrating when all you want it to help them but never knowing what to do. We see the GP, SENCO, Bladder Clinic and OT and I’m still non the wiser on what to do to help. Just feel like I’m failing him at times, especially having 3 other children who are now adults but all potty trained with ease.

If you suspect adhd/asd then he may lack propriception which is the ability to feel sensations, so can’t tell when he needs to go. Occupational therapy exercises can improve this, lots online or in person even better if you can afford.

Has he ever had any of these: very long poos/rabbit pellet poos/witholding poo/leaking poo, even if it was years ago?

If so, it’s likely he could be impacted, which stretch’s the rectum and puts pressure on the bladder, desensitizing it as well. If so he needs a disimpaction regime to clear the blockage, not 1 sachet per day which is maintenance.

Even with impaction they can still poo daily, new poo travels around the old poo. So it goes undetected. They are big on x rays to find this in US and treat it with suppositories/enemas. In the UK, doesn’t seem to be a thing but some manage to push for a x ray to check.