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Floating Hospital offers gentle, drug-free remedies to children struggling with wetting problems.

04/01/2013

Gentle but effective treatment for your child struggling with wetting problems

For children aged six and older who struggle with nighttime or daytime wetting, Floating Hospital for Children offers a non-invasive and drug-free solution with a well-established track record.

“It basically involves physical therapy via biofeedback for the pelvic floor,” explains Director of Pediatric Neuro-Urology Jeremy Wiygul, MD. “For treating persistent voiding problems in preadolescent kids – before adolescence and after toilet training – this is the recommended first-line approach versus medication like Ditropan (oxybutynin).”

And it delivers results.

“This program can definitely help with wetting problems and overcome the social issues that come along with it,” Wiygul says, noting that about 70 percent of his patients report an improvement, a response rate consistent with several broad-based outcomes analyses. “It also places the child in control which, in my experience, is the single most important factor in overcoming the problem.”

Working together to help your child

In biofeedback sessions, sensors are placed on the child’s sphincter muscles. The child is then instructed to contract the muscles, and a figure on the computer screen moves in response.

“It graphically represents to the child how to become more aware of the sphincter muscles, and we can show parents how the child is improving over time,” he says. Parents are present during the biofeedback sessions to provide encouragement, and kids are given “homework” in the form of Kegel exercises. Parents also are asked to fill out a log to document the child’s voiding habits and diet between biofeedback sessions.

In fact, Wiygul has developed an Apple®-platform smartphone and tablet app called “HapPee Time” to help support and encourage compliance. The app, which also will be available soon for Android™ devices, enables parents and kids to track what children eat and drink to get a clear picture of what may be affecting their ability to avoid wetting.

“Parents – or children – can track these behaviors in the app and, at the end of therapy, email results to me or the treating physician,” he explains.

Wiygul points out that there is a large percentage of patients whose bedwetting issues resolve simply by treating them for constipation.

“It’s very common for constipation to be the main issue, and I don’t think that’s widely known,” he says. “But it’s really the biggest contributing factor in wetting. So my advice to referring pediatricians is to first evaluate the child for constipation. It’s amazing how often patients can avoid additional testing and doctors’ visits simply by having their constipation treated.”

“If a child doesn’t have constipation or doesn’t respond to treatment, then refer him or her for a biofeedback consultation,” he adds.

Meet with an expert to help your child

Wiygul offers initial consultations at Floating Hospital in downtown Boston as well as at MetroWest Medical Center in Framingham. Because the biofeedback equipment is currently only available at Floating Hospital, the treatment occurs there.

“The first thing I tell patients and parents after taking a history is that ‘this will resolve,’” he says. “I always try to emphasize that wetting is much more common than they realize, and we know this from epidemiological studies as well as from clinical experience.”

“I don’t recommend biofeedback unless I think it’ll really help, and I administer it myself,” he adds, noting that the Floating Hospital program is one of only two in Boston where biofeedback is personally administered by a doctor. “Here at Floating, it’s highly personalized, used judiciously and it definitely can help.”

To refer a patient to Dr. Wiygul, call 617-636-5360.