Wetting in Children and Adolescents: A Practical Guide for Parents, Teachers, and Caregivers

Alexander von Gontard; Prof., MD is affiliated with the Department of Child and Adolescent Psychiatry, Saarland UniversityHospital, Homburg, Germany

Aims of this guideHow should I use this guide?1 General Information on Wetting1.1 Does this sound familiar to you?1.2 What is the definition of wetting?1.3 What common types of wetting are there?1.4 How common is wetting?1.5 What are the causes of wetting?1.6 Could my wetting child have a psychologicalproblem?1.7 Which examinations are needed for the assessmentof wetting?1.8 How should wetting be treated?2 Soiling2.1 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 beforewetting?3 Daytime Wetting3.1 What are the three most important types ofdaytime wetting?3.2 What is urge incontinence?3.3 What is voiding postponement?3.4 What is dysfunctional voiding?3.5 What to do if treatment fails?3.6 How is daytime wetting treated if my child hasspecial needs?3.7 Why should daytime wetting be treated first?4 Bedwetting4.1 What is simple bedwetting?4.2 What are typical symptoms of simple bedwetting?4.3 What is bedwetting?4.4 What subtypes of bedwetting are there?4.5 What are the causes of bedwetting?4.6 What examinations are necessary for theassessment 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?4.11 When is medication a useful treatment option?4.12 What to do if treatment fails?4.13 How is bedwetting treated if my child hasspecial needs?4.14 Summary5 Wetting and Psychological Problems5.1 How common are psychological problems anddisorders in children who wet?5.2 In which types of wetting are psychologicalproblems especially common?5.3 Which types of psychological problems and disordersare most common in children who wet?5.4 How do you treat wetting if psychological problemsor disorders are present?6 Concluding RemarksFurther ReadingAppendicesAppendix 1 Enuresis / Urinary Incontinence QuestionnaireAppendix 2 48-Hour Toilet ChartAppendix 3 Drinking ChartAppendix 4 Urge Incontinence ChartAppendix 5 Voiding Postponement ChartAppendix 6 Bedwetting Baseline ChartAppendix 7 Documentation of Alarm TreatmentAppendix 8 Dose Titration Chart for Oral Desmopressin