Continence issues Grade 1

[~me~]

My DS2 seems to have continence issues. He is in Grade 1, turns 7 in August. He does not have any learning difficulties or behaviours otherwise.

His history is we had a horrendous time TT him. It was more poo related than wee. He has been OK with wee, it seems to be getting worse. I am aware night is not even considered a problem until at least 8yrs old.

He cannot hold onto his wee. When he has to go, he has to go immediately and often it leaks out before he gets there. I am not sure if he doesn't have a strong sensation or if he has a genuine problem.
I plan on taking him to our local GP against friends and family advice as they seem to think it's a lazy problem rather than continence problem.

It's a during the day problem, he just does not seem to make it on time.

We are about to start putting spare underware and pants in his bag.

Does anyone have a child with a continence problem? Did you take him or her to the GP? What was the outcome?

Any advice would really be appreciated.

[Rivlas]

You are doing the right thing by getting it looked at. It might be nothing but for peace of mind get it looked at.

Send a note to the teacher and let him/her know that he needs to go to the toilet straight away and get them to keep a diary of how many times he needs to go while in class.

[Phteven]

Yes. I took DS1 to our GP when he was 6 about his bedwetting (he had never had a single dry night and often wet the bed more than once in a night) and we were referred to a continence physio.
I really disagree with the wait until they are 8 philosophy. Children are smart enough to know that other children don't have continence issues and it makes them unhappy no matter how understanding and relaxed their parents are. We never once criticised DS for his bedwetting or even discussed it in front of him and he was thrilled when we took him to the Dr because he wanted help. I hadn't even realised how much it upset him until I saw how happy he was when he saw the light at the end of the tunnel.

Our physio sees people without referrals but the referral can affect whether PHI covers it.

[shellbell3]

I would def go and see about it. A continence nurse or someone specifically trained in that area will be able to organise a plan with you and your son. There are a few types of incontinence and sounds abit like urge incontinece, usually your bladder gets filled to a certain point and sends signal to your brain that you need to go then your brain sends signal to the bladder to hold on til an approriate time. Somewhere that signal is getting lost, your son gets the message he needs to go and he goes.
The continence person plus the DR will work on what the cause is behind this and work on what can be done to help.

[Santosha]

We've used Conquip (can be found through googling Conquip Melbourne) through my work and found Elaine and the nurses who work with her to be brilliant - well worth giving them a call to find out if you are eligible for their services.

Good luck to you and your little guy. xox

[~me~]

Thankyou so much for the information. At least I can into the GP with my wits about me after reading this.

We have PHI, I don't care how much it will cost to help him.

I will look up Conquip and see how it works, I will ask the GP about it as well.

[myturn]

I agree with the others, definitely when they are school its important to start getting things looked at ,even if it just sets a baseline or a beginning level of where he is at.

Id also suggest toilet timing him, so he goes regularly whether or not he thinks he has to go, this may ere net the accidents as he's going regularly anyway. The school might find it frustrating, but push the issue to get them to help and ensure he goes regularly enough to prevent the issues. The school may be able to access a psychologist to help with planning that strategy if needed.

Good luck!

[Phteven]

Sorry. But no. Going to the toilet when you don't need to/just in case won't fix anything and can trigger more issues.
It's a bad habit that isn't good for anyone's bladder/continence.

[myturn]

Sorry. But no. Going to the toilet when you don't need to/just in case won't fix anything and can trigger more issues.
It's a bad habit that isn't good for anyone's bladder/continence.

I think it depends on what you are trying to achieve, I didn't mean to suggest he go when he doesn't need to but I have seen toilet timing work effectively.

I am not a continence specialist however, its just IMHO from what I have seen help some children in the schools I've worked in. Definitely find a specialist to give you the right advice that is specifically designed for your child's needs.

[Yael]

There is a good paediatric continence clinic @ monash medical and at the RCH. DS has special needs and is night incontinent, but I think they see neurotypical kids also. Monash has a huge waiting list (took us 8 months), but RCH is a lot quicker. They were so good at listening and to what would work for our family. We could access almost $550 in funding for nappies, but that might be for the special needs, and also got 1 waterproof doona protector, 2 mattress protectors, 3 of those mats to go over he sheets & 2 pillow protectors. That was through the SWEP program. At the appointemnt they had a specialist paed, a continence nurse & a continence physio to consult with.

At 6 I think it should be dealt with, I would not wait longer, as all my reading says waiting longer makes it worse (especially for fecal incontinence).

I would call the hospitals directly to see if you are eligible, or being seeing a paed and asking for help.

Good luck, let me know if you need any help.

[~me~]

We have a positive outcome. Initially I thought the GP was going to brush it off as just lazy. He has had his urine tested and it has come back clear of any underlying UTI.
We now have a referral for the Enuresis clinic at the RCH. The GP faxed it off today, just need to wait. I will follow it up with a phone call in a few days.

I also have a meeting with his Teacher next week.

I am very happy to finally get this looked into. He has been coming home wet most days, not fully saturated, he is just not making it on time. He is confused as he says he 'finishes' it off in the toilet.

[Santosha]

So glad to hear the doc took you seriously and you've got a goood referral. I hope the teacher is willing to work with you and find strategies that work best for your little guy.
Keep us posted. xox

[shellbell3]

That's great you've got help in sight. I'm sure your son will be a lot happier to to get things sorted. Keep us updated

[~me~]

He is being checked out for something called 'bladder irritability'.
When we get a half full bladder, a message goes to our brain that we need to go soon then we go.
He seems to be not getting that message and literally runs to the toilet albeit too late.
The Paediatrician also said constipation can hinder the message as bowel and bladder are next to each and if he has a full bowel then it can interrupt bladder function...somehow? I had to think of how often he does a poo and it is not every day and he has had constipation issues in the past when he was alot younger.

At this stage she has put a 'toilet routine' in place for him until the U/S. Have had a few accidents still even with that in place.
We have another issue which makes it hard for him to remember the routine, we are going through the motions of 'auditory processing', first thing is a hearing test then take it from there.


The U/S is going to be tough going on him as he needs to have a full bladder before and then go to the toilet and check again.

[shellbell3]

Hopefully you get answers and then can set a plan in place. The fun now of appointments and tests and follow ups.
How is he coping with it all?

[Phteven]

DS had to get an ultrasound. It wasn't as bad as I thought it would be.
We used benefibre to eliminate any constipation issues.

[AnyDream]

Definitely talk to your GP. They should refer you to a continue nurse/service who will assess your DS and work out where the problem is, and come up with some good age-appropriate strategies.

In the meantime, definitely put the spare clothes in, get a note to the teacher (so they know never to delay him when he asks to use the toilet) and take it from there.

My DD1 had a problem with drops of wee escaping (around grade 3 from memory) and near-misses. GP did a wee test (to make sure there was no underlying infection) and then sent us to the continence nurse. We had to keep a record (including measuring the wee for a couple of days) and then the nurse taught DD some strategies for knowing when she needed to wee. It took DD a little practice but over a couple of months the problem was resolved. The nurse was great, very friendly and reassuring.

ETA:
Sorry, I just caught up with the rest of the thread. That's great you're starting to get some answers, and very interesting that he's also being checked for auditory processing stuff. It makes sense that there might be a relationship between sensory processing and toileting, when you think about it. Good luck as you go forwards with both of these investigations.