Wetting in Children and Adolescents E-Book

Alexander von Gontard

• Herausgeber: Hogrefe Publishing
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2016

Seitenzahl: 101

Beschreibung

Step-by-step guidance for parents and carers on helping children and adolescents achieve dryness Wetting is a distressing problem that is common in children and can also affect adolescents. This clearly written book shows parents and carers how to assess and treat wetting problems effectively. Whether the problem is daytime wetting, bedwetting, or wetting with soiling, the chapters provide step-by-step instructions and concrete ideas to help children and adolescents achieve dryness. All recommendations are based on the latest scientific studies and guidelines such as those of the International Children's Continence Society (ICCS). Useful charts and questionnaires help identify the exact problem, track progress on a daily basis, and increase motivation. This practical guide is ideal for parents as well as for teachers, educators, and caregivers.

Leseprobe

Wetting in Children and Adolescents

A Practical Guide for Parents, Teachers, and Caregivers

Alexander von Gontard

Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany

About the Author

Prof. Alexander von Gontard, MD, is the director of the Department of Child and Adolescent Psychiatry, Saarland University Hospital, Germany, and holds the Chair for Child Psychiatry. He was trained in pediatrics, child psychiatry, and psychotherapy and has researched and published widely on incontinence in children and adolescents.

Library of Congress Cataloging in Publication information for the print version of this book is available via the Library of Congress Marc Database under the Library of Congress Control Number 2016930839

Library and Archives Canada Cataloguing in Publication Data

Gontard, Alexander von

[Einnässen. English]

Wetting in children and adolescents : a practical guide for parents, teachers, and caregivers / Alexander von Gontard (Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany).

Translation of: Einnässen: Informationen für Betroffene, Eltern, Lehrer und Erzieher.

Includes bibliographical references.

Issued in print and electronic formats.

ISBN 978-0-88937-488-1 (paperback).--ISBN 978-1-61676-488-3 (pdf).--ISBN 978-1-61334-488-0 (epub)

1. Enuresis. 2. Enuresis--Etiology. 3. Enuresis--Treatment. 4. Enuresis--Psychological aspects. I. Title. II. Title: Einnässen. English.

RJ476.E6G6513 2016

618.92’849

C2016-901984-5

C2016-901985-3

This present volume is an adaptation and translation of A. von Gontard & G. Lehmkuhl, Ratgeber Einnässen (2012, ISBN 978-3-8017-2451-1), published under license from Hogrefe Verlag GmbH & Co. KG, Göttingen, Germany.

© 2012 by Hogrefe Verlag. Translated and revised by Alexander von Gontard, 2016.

The authors and publisher have made every effort to ensure that the information contained in this text is in accord with the current state of scientific knowledge, recommendations, and practice at the time of publication. In spite of this diligence, errors cannot be completely excluded. Also, due to changing regulations and continuing research, information may become outdated at any point. The authors and publisher disclaim any responsibility for any consequences which may follow from the use of information presented in this book.

Registered trademarks are not noted specifically in this publication. The omission of any such notice by no means implies that any trade names mentioned are free and unregistered.

The cover image is an agency photo depicting models. Use of the photo on this publication by no means implies any connection between the content of this publication and any person depicted in the cover image.

© 2017 by Hogrefe Publishing

http://www.hogrefe.com

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Cover image: © Agnieszka Kirinicjanow – istockphoto.com

Format: EPUB

ISBN 978-0-88937-488-1 (print) • ISBN 978-1-61676-488-3 (PDF) • ISBN 978-1-61334-488-0 (EPUB)

http://doi.org/10.1027/00488-000

Citability: This EPUB includes page numbering between two vertical lines (Example: |1|) that corresponds to the page numbering of the print and PDF ebook versions of the title.

Table of Contents

Aims of this guide

How should I use this guide?

1 General Information on Wetting

1.1 Does this sound familiar to you?

1.2 What is the definition of wetting?

1.3 What common types of wetting are there?

1.3.1 Nighttime wetting

1.3.2 Daytime wetting

1.4 How common is wetting?

1.5 What are the causes of wetting?

1.6 Could my wetting child have a psychological problem?

1.7 Which examinations are needed for the assessment of wetting?

1.8 How should wetting be treated?

2 Soiling

2.1 What is the definition of soiling?

2.2 How common is soiling?

2.3 What common types of soiling are there?

2.4 How do you recognize soiling with constipation?

2.5 How does soiling with constipation develop?

2.6 How do you recognize soiling without constipation?

2.7 How should children with soiling be treated?

2.8 What is toilet training?

2.9 How do you treat soiling with constipation?

2.10 Might other therapies be needed?

2.11 Why should soiling always be treated before wetting?

3 Daytime Wetting

3.1 What are the three most important types of daytime wetting?

3.2 What is urge incontinence?

3.2.1 How do you treat urge incontinence?

3.2.2 When is medication needed for treating urge incontinence?

3.2.3 How do the drugs for treating urge incontinence work?

3.3 What is voiding postponement?

3.3.1 How do you treat voiding postponement?

3.4 What is dysfunctional voiding?

3.4.1 How do you treat dysfunctional voiding?

3.5 What to do if treatment fails?

3.6 How is daytime wetting treated if my child has special needs?

3.7 Why should daytime wetting be treated first?

4 Bedwetting

4.1 What is simple bedwetting?

4.2 What are typical symptoms of simple bedwetting?

4.3 What is non-monosymptomatic bedwetting?

4.4 What subtypes of bedwetting are there?

4.5 What are the causes of bedwetting?

4.6 What examinations are necessary for the assessment of bedwetting?

4.7 How do you treat bedwetting?

4.8 Which treatments are ineffective?

4.9 What are observation charts?

4.10 What is alarm treatment?

4.10.1 Is alarm treatment suitable for you and your child?

4.10.2 How does alarm treatment work?

4.10.3 How effective is alarm treatment?

4.10.4 How common are relapses?

4.10.5 When should alarm treatment be combined with other therapies?

4.10.6 When should you stop alarm treatment?

4.11 When is medication a useful treatment option?

4.11.1 Which medications have a positive effect on bedwetting?

4.11.2 How does treatment with desmopressin work?

4.11.3 When is treatment with antidepressants recommended?

4.12 What to do if treatment fails?

4.13 How is bedwetting treated if my child has special needs?

4.14 Summary

5 Wetting and Psychological Problems

5.1 How common are psychological problems and disorders in children who wet?

5.2 In which types of wetting are psychological problems especially common?

5.3 Which types of psychological problems and disorders are most common in children who wet?

5.4 How do you treat wetting if psychological problems or disorders are present?

6 Concluding Remarks

Further Reading

Appendices

|1|Aims of this guide

The aim of this guide is to provide information on the different types of wetting and their causes as well as on how to assess and treat them effectively. The information is intended mainly for parents but may be useful for teachers, educators, caregivers, as well as older children and adolescents. The objective of this guide is to give short and precise advice on the most important forms of wetting that might affect children and adolescents during the day and/or during sleep. This guide provides practical advice, step-by-step instructions, and concrete recommendations on how to achieve dryness. To make it more understandable, everyday terms such as bedwetting, daytime wetting, and soiling are used throughout the book instead of the scientific terms. Please feel free to copy the charts and materials included in the appendix and use them for your child.

This guide was first published in 2004 and received positive feedback from many parents, leading to the publication of a revised edition in 2012. As there are no comparable guidebooks in the English language, the time had come to make this information available for parents all over the world. Due to the many new developments, the book was not just translated but was brought up to date with many innovative aspects. All recommendations are based on current scientific studies and international guidelines. We considered both European and North American practice parameters and specifically followed the recommendations of the International Children’s Continence Society (ICCS). The ICCS is a multi-professional, international organization that has set out to standardize the |2|treatment of incontinence in children based on the newest scientific evidence. Following ICCS recommendations is the best way to ensure the welfare of children being treated for incontinence.

As many children not only wet but are also affected by soiling, a separate companion guide is available for this type of incontinence (Soiling in children and adolescents: A practical guide for parents, teachers, and caregivers; Hogrefe Publishing, 2017).

I would like to thank Hogrefe, and especially Mr. Robert Dimbleby and Ms. Juliane Munson, for their enthusiasm and support of this project. I hope very much that this guide will be of help to many families to achieve continence.

Saarbrücken, Germany, June 2016

Alexander von Gontard

|3|How should I use this guide?

The aim of this guide is to provide the reader with information that is organized as logically and explained as simply as possible. Although the topic of this book is wetting, Chapter 2 deals with soiling. The reason for this is that many children, unfortunately, are affected by wetting and soiling with or without constipation. If this is the case, it is necessary to deal with the child’s soiling/constipation first. Because of possible complications and less favorable outcomes, bedwetting should be treated after the child has stopped wetting during the day.

Answer the following questions to find out how to best use this guide:

Does my child soil or is he or she constipated? If yes, begin with Chapter 2.

Does my child wet during the day – no soiling or constipation present? Then you can skip Chapter 2 and go straight to Chapter 3.

Does my child wet at night – no daytime wetting, no soiling or constipation present? Then you can skip Chapters 2 and 3 and start with Chapter 4.

Does my child have other psychological problems or disorders which cause him or her more than just distress? In this case, it would be useful to read all relevant chapters and to follow the recommendations given there. Make sure to carefully read Chapter 5 and to find out whether additional mental health treatment might be needed.

The aim of this guide is to provide you with practical information on wetting. However, it is important that you |4|seek professional help. Because medical causes of wetting have to be identified – or ruled out – before treatment can begin, every child or adolescent needs to be examined by a pediatrician or general practitioner. For good assessment, it can be of great help to fill out the Enuresis Questionnaire (Appendix 1) and the 48-Hour Toilet Chart (Appendix 2) before consulting your physician. Please discuss the charts and any questions you might have with your physician or therapist.

The remaining charts and materials in the appendix can be useful later during treatment. The Drinking Chart in Appendix 3 documents the drinking habits of your child with the aim of increasing the amount your child drinks. The charts in Appendix 4 and 5 are used in the treatment of daytime wetting, those in Appendix 6, 7, and 8