Case study - daytime wetting 9 yr old

9 yr old boy still wets the bed despite years of intermittent bed wetting alarm use and also sometimes has daytime accidents.

• He sometimes can go weeks without any problems.

• It is affecting his self confidence and he is afraid to go on school camps and has stopped attending cubs.

• He has seen several GPs over the years to rule out things like UTIs. The common response is "don't worry, he will grow out of it”.

• Some concerns re attention and concentration

• Doesn't drink much during the day especially at school.

• Parents not able to verify regularity or type of bowel motions

• Currently use a Therapee bell and pad alarm - usually reliable. He gets sweaty at night so occasionally has false alarms and is often difficult to rouse after alarm goes off.

• Wets often small amounts during the day and at night but can be dry for many days as well

• Sometimes takes himself to the toilet to wee but often parents see him doing a "wee dance" and make him go

Treatment

• Seen 5x in therapy

• After closer monitoring of his poos, a laxative was introduced and advice given regarding the importance of daily soft bowel motions

• Records kept to monitor frequency of daytime/nighttime wetting and type and frequency of bowel motions

• Education provided to child and parents regarding the importance of daily fluids and restricting fluids prior to bed

• Advice given regarding the correct application of behaviour modification techniques

• Alarm discontinued

Outcome

• Completely dry at night and no longer requires an alarm

• Independently takes self to the toilet for both wees and bowel motions during the day and no longer requires adult direction

• Completely dry during the day

• Advice given re the ongoing use of laxatives in the short term to maintain success