Does Motivational Therapy work?

Ferrara et al. (2018) compared desmopressin, motivational therapy, and desmopressin with motivational therapy.  They studied 137 patients with a mean age of 8.8 years. They evaluated the child’s response at 3 months.  Motivational therapy included: avoiding punishment, having a supportive environment, remembering that bedwetting is not the child’s fault, management of constipation, tracking wet and … Read moreDoes Motivational Therapy work?

Late night eating

I often take care of kids on desmopressin (DDAVP). This is a medication that children take at night to decrease the amount of urine they produce.  I’m shocked that patients take it without any drinking restrictions, this can be a dangerous practice.  However, I’ve never asked them to change their eating practices. Michelet et al. … Read moreLate night eating

Constipation and Wetting

The correlation between constipation and wetting is very commonly overlooked.  Sampaio, Sampaio Sousa, Fraga, Veiga, Netto & Barroso (2016) interviewed 829 children and 9% had urinary symptoms.  Of those children with urinary symptoms 35% also had constipation.  Only 8% of kids without urinary symptoms had constipation alone.  Kids that void infrequently and are considered “holders” … Read moreConstipation and Wetting

Bladder Basic Advice decreases wet nights

Tkaczyk, Maternik, Krakowska, Wosiak, Miklaszewska, Zachwieja, Runowski, Jander, Ratajczak, Korzeniecka-Kozyrska, Mader-Wolyriska, and Kilis-Pstrusinska (2017) wanted to evaluate the treatment rate of basic bladder advice after 3 months.  They evaluated 49 bedwetters and assessed them at 30, 60, and 90 days.  The intervention was bladder basic advice which included, information on what causes bedwetting, proper volume … Read moreBladder Basic Advice decreases wet nights

A great Intro Article

Jain and Bhatt’s article suggests that a provider obtain a thorough history, physical examination, reviews a voiding diary to see how much their bladder can hold throughout the day, and urinalysis.  No other testing is needed if the patient does not have daytime urinary symptoms or other red flags. There are two treatment modalities: pharmacologic … Read moreA great Intro Article