Physiotherapy for Children’s Continence
My daughter was diagnosed with overactive bladder syndrome (OAB) at the age of seven and was having daytime and nighttime wetting daily. I found there was very little support available for parents and children other than medication.
I therefore undertook training to be able to provide physiotherapy for Children’s Continence in order to be able to help her. I have developed this service since as I believe it is really important and there is a massive lack of provision in this area of healthcare.
My daughter is now dry both day and night and I work in Children’s Continence both in private and NHS settings.
Incontinence is defined by the International Children’s Continence Society as involuntary wetting at an inappropriate time and place in a child 5 years old or more.
It is divided further into daytime incontinence and nighttime incontinence (enuresis).
Daytime incontinence can be further categorized:
- Overactive bladder – children with urgency (increased voiding frequency and/or incontinence often present)
- Urge incontinence
- Stress incontinence
- Giggle incontinence
- Voiding postponement – children who are observed to habitually postpone voiding using holding maneuvers
The prevalence of daytime incontinence ranges between 30% at age 4 to 1.8% of 15-17 year olds.
The prevalence of enuresis (nighttime incontinence) diminishes from 40% of 5 year olds to 3% of 15-17 year olds.
Urotherapy
Urotherapy is non-surgical, non-pharmacological (medication) treatment for incontinence.
It involves:
- Education
- Intervention
- Life-style advice
- Support and encouragement
The aims are to:
- Normalise bladder emptying
- Normalise bladder filling
- Facilitate age-appropriate storage
- Facilitate optimal bowel function
- Normalize defaecation dynamics
The end goal being to have no more symptoms, wetness or urgency.