“He was 8 years old and still wearing diapers. We knew he had a problem.” – Mother of a boy with a bedwetting issue
“It really wasn’t difficult to talk about her wetting as she knew something was wrong. We concentrated on making her comfortable and assuring her all would be fine.” – Mother of a young girl with a wetting problem
Urinary incontinence, otherwise known as “enuresis” or “wetting,” is fairly common, often embarrassing and sometimes difficult to talk about it. Of children 6 to 7, about 20 percent of boys and 17 percent of girls have some problem with daytime or nighttime wetting. Still, many kids are reluctant to talk about wetting with parents, friends and teachers. Parents themselves often have a hard time confronting the issue.
The Voiding Improvement Program (VIP) at Boston Children’s Hospital uses noninvasive methods to help children overcome incontinence and other urinary issues, such as urinary tract infections. Treatments can include biofeedback training, Reiki therapy, behavioral therapy and referral for acupuncture. The program’s director, Carlos Estrada, MD, believes that open communication is the essential first step in addressing a wetting issue.
“Kids have a hard time talking about their wetting problems for one obvious reason: It’s embarrassing,” he says. Over time, that embarrassment can build and build. In fact, Estrada explains, for some boys and girls, urinary incontinence “becomes a focal point for a family, and the negative attention results in kids turning inward.”
Watch this video to learn how Boston Children’s offers treatment for bedwetting:
Adding to the embarrassment are feelings of helplessness. Estrada says that wetting the bed at home or having an accident at school or on the playground can trigger these feelings and cause kids to postpone voiding. “Holding too long can lead to an overactive bladder and possibly more serious problems,” Estrada reports. …
The Voiding Improvement Program (VIP) at Boston Children’s Hospital helps kids overcome a wide variety of urinary problems, including difficult toileting issues like daytime and nighttime bathroom accidents and urinary tract infections. Here’s a look at how the VIP can help your children.
Boston Children’s Hospital Voiding Improvement Program (VIP) is available in Boston, Peabody, Waltham and Weymouth. To learn more, visit the program’s website. Also, check Thriving in the coming weeks for a post on how parents and doctors work together to help kids overcome daytime and nighttime wetting issues.
Back to school time can be nerve-wracking for many children. Uncertainty about new classmates, teachers and homework requirements can stir up anxiety in even the most outgoing kids. But for children with voiding issues (bed and pants wetting), this time of year can be especially traumatic: The anticipation of dealing with it at school can be overwhelming for many kids and their parents.
In addition to the emotional strain caused by urinary incontinence, there can be serious medical concerns associated with the condition. Urinary tract infections and irrirative voiding symptoms are common side effects of several voiding conditions. If left untreated they can have long lasting consequences.
Fortunately for many local parents, there’s hope. Boston Children’s Hospital Voiding Improvement Program (VIP) offers individualized treatment through state of the art technology, ancient relaxation techniques—and everything in between—to help children overcome their wetting issues.
“The kids in our program are generally at an age where bed wetting and wetting their pants can really negatively impact their lives,” says Carlos Estrada, MD, a Boston Children’s urologist and VIP director. “The anxiety and stress that accompanies these issues can be very hard for everyone to deal with.”
In a majority of cases treated by the VIP team, the urinary problems are more emotional than medical, but establishing that fact is an important first step.
“The very first goal of the program is to make sure we’re not missing a more serious medical cause of the child’s voiding issues,” Estrada says. “The good news is most times we’re not. Usually, the patients we see do not have a significant, underlying medical reason for their problem. And if they do, we’ll catch it early, which is important for customizing their treatment and addressing the problem quickly.”
Once the cause of the child’s wetting problem has been established a team of urologists and nurse practitioners get to work creating an individualized treatment plan that works best for that particular child. Depending on the patient’s needs, the following are examples of treatments offered by the program:
For many urinary problems, counseling is important tool for lessening anxiety about wetting. Often the child will be stressed about the problem, and that anxiety can then exasperate their symptoms. To offset this cycle, the VIP staff meets with the parents and child, and together they find ways to reduce frustration and emotional stress caused by their urinary dysfunction.
“A lot of these problems are rooted in children being very upset by their condition, but just telling someone to relax is a pretty vague request,” Estrada says. “Our treatments are more interactive and help the child discover the stress reducing techniques that work best for him or her.”
Biofeedback is a treatment technique that teaches people to improve their health by using signals from their own bodies. In the VIP program, non-invasive electrode pads can be used to monitor a patient’s muscle movements in order to determine how and when a child tenses up during urinating and study how full or empty their bladders are after going to the bathroom. With this information specialists can help identify potential obstacles to proper voiding and work with the patient and family on correcting them.
“By objectively analyzing where a patient’s problems are, you can more directly address their individual needs,” Estrada says. “By teaching these kids how to relax their muscles and mind we see drastic improvement in their ability to void appropriately.”
Reiki and Acupuncture therapy
Reiki and acupuncture have proven to be useful in reducing stress, which is often a key component of the VIP patients’ conditions.
Provided by Boston Children’s Integrative Therapies Team, Reiki is a holistic treatment that encourages healing through gentle touch. Acupuncture has been used to alleviate pain and treat diseases for more than 2,000 years. Acupuncture care at Boston Children’s is done by licensed physicians who specialize in the practice.
“Parents need to remember that [wetting] issues are extremely common, they’re not anyone’s fault and they are treatable.”
The VIP will soon be expanding beyond Children’s main campus. In September, the program will also be available at Boston Children’s Hospital at Waltham. By offering the program in an additional location, Estrada is hopeful that he and his team will help even more struggling families deal with this difficult but treatable condition.
“Both emotionally and physically, urinary problems can be very stressful on families,” he says. “But parents need to remember that these issues are extremely common, they’re not anyone’s fault and they are treatable. The more people who are aware of that the better.”