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Bedwetting and Special Needs Children

How Treatment Varies With Age

By Lyn Mettler

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Many parents struggling with a child's bedwetting may wonder at what age they should start to worry or when they should go to the doctor. There are no hard and fast rules when it comes to bedwetting, especially when you're talking about children with special needs, who come with a variety of different challenges.

"Overall, it's a very mixed bag," says Dr. Eric Jones, assistant professor of urology at Texas Children's Hospital in Houston, Texas. "It really depends on the nature of the underlying special need."

One thing that he can say for sure, however, is that enuresis – or bedwetting – is not abnormal before the age of 6 for any child. "Nighttime is usually the last part of continence to develop."

Severe Disabilities

For many children, especially those with more severe disorders, incontinence is simply caused by their disability. In this case, parents know the cause and usually whether it can or cannot be fixed.

For example, children with spina bifida often have difficulty with wetting during both the day and night. According to Dr. Jones, these kids don't have the normal architecture of the nervous system to allow control over wetting.

This often requires surgery, which takes place " ... when the family is ready socially to undertake surgery, and when the patient is ready to take care of themselves," he says. After surgery, the child has to use a catheter several times a day, so it is appropriate to wait until they are developmentally ready to help in the process. Usually, this is around 8 to 10 years old.


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