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Suggest Treatment For Lack Of Bladder Control In A Child

Posted on Mon, 10 Aug 2015

Question: HI,
My Kid is Meningocele by birth which was operated when he was 2 months. Now he is 8 years old having incontinence and loose control on bladder.
Daily we are using Suppository(Gerbisa) to empty his bowl but still he cant pass his stool fully. He will do it 1-2 times daily.
Please let know incase treatement or medicine required. Will it casue any future problems.

Answered by Dr. Sumanth Amperayani (46 minutes later)

Brief Answer:
I have a few questions for you

Detailed Answer:
Hi..I understand your concern....I have a few questions for you.

1. You mentioned that he's having loss of bladder control and motion control now.... Does that mean that he had good control all these days?

2. If it is so when exactly did he lose his control?

3. Are you doing clean intermittent catheterization for his urine voiding?

4. Did he have any urinary tract infections in the past?

5. Is he able to walk without support ?

6. Does he have any seizures?

Please get back to me with answers and I will be glad to guide you further.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (39 minutes later)

Hi Please find below details-

1. You mentioned that he's having loss of bladder control and motion control now.... Does that mean that he had good control all these days?- Since birth he is having loose control on Bladder and Urine.Its improved bit now a days(better than Past). But still problem is there. His stool is hard cant pass on his own without suppository daily. He cant sense the same without suppository.
2. If it is so when exactly did he lose his control? By Birth
3. Are you doing clean intermittent catheterization for his urine voiding?. Did he have any urinary tract infections in the past?-No We have not done any catheterization for his urine voiding. Also There was mild urine infections inpast but it was cured.
5. Is he able to walk without support ?-Yes his all physical activities are normal except urine and stool control.
6. Does he have any seizures? No

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Suggestions on bladder and bowel control

Detailed Answer:
Hi.... I am happy to hear that he's actislly OK improving. There are 2 issues -

1. Bladder control / incontinence.
2. Loss of sensation of stretching of rectum.

My suggestions on these -

1. For bladder control - I usually advice clean intermittent catheterization. This is done to evacuate the bladder to prevent stasis of urine, and prevent further urinary tract infections.

2. For bowel control - rather than using every time a suppository, I suggest you use Lactulose suspension as you say that the stool is very hard.

These things have to be taught and prescribed by a physician. I suggest you see your pediatrician for this.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (40 hours later)

HI,
Thanks for your valudable suggestion.

For Bladder control My general physician has suggested Cremaffin daily half T spoon b4 going to bed.

Please let know if he we can have any alternate way to empty his bowl at onetime.

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
I suuggest Polyethylene Glycol

Detailed Answer:
Hi....I suggest you use polyethylene glycol, which is available commercially as MuOut powder with instructions on the container. The other commercial preparation is Peglec.

I think this will be a better laxative than Cremaffin to empty the bowels.

Regards - Dr. Sumanth

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj