Enuresis is the medical term for bed-wetting. Bed-wetting is quite common during the childhood phase and professionals view it as a developmental stage. The majority of doctors view "a bedwetting child" to be any girl older than the age of four and any boy over the age of five who wet the bed. Bedwetting generally disappear with age. In a few number of cases, bedwetting can continue into adulthood. Bed-wetting is also more common amongst boys than girls.

Enuresis is divided into Primary and Secondary Enuresis. Bedwetting is considered to be PRIMARY if the child has never been dry at night, or is hardly dry at night. Bedwetting is considered to be SECONDARY if the child has been dry at night for a considerable length of time.

 What causes bedwetting?

• Genetic conditions (it usually runs through the family)
• Difficulties waking up from sleep or deep sleeping patterns. Actually these children sleep so deeply that they are not aware of the message the bladder sends to the brain saying it is full.
• Stress or anxiety
• Slower than normal development of the central nervous system (which reduces the child's ability to stop the bladder from emptying at night)
• Hormonal factors (not enough antidiuretic hormone is produced, which is the hormone that slows urine production at night)
• Urinary tract infections
• Abnormalities in the urethral valves in boys or in the ureter in girls or boys
• Abnormalities in the spinal cord
• Neurologically immature bladder or a small bladder

What are the treatments for bed-wetting?

Most children outgrow bed-wetting without treatment. However, you and your doctor may decide on your child's treatment depending on the child's condition. There are 2 kinds of treatment: behaviour therapy or medicine. Behaviour therapy helps teach your child not to wet the bed. Some behavioural treatments include the following:

• Limit fluids before bedtime.
• Have your child go to the bathroom at the beginning of the bedtime routine and then again right before going to sleep.
• An alarm system that rings when the bed gets wet and teaches the child to respond to bladder sensations at night.
• A reward system for dry nights.
• Asking your child to change the bed sheets when he or she wets.
• Bladder training: having your child practice holding his or her urine for longer and even longer times during the day, in an effort to stretch the bladder so it can hold more urine.

Medical treatment

The doctor may give your child medicine if the child is 7 years or older and if behaviour therapy has not worked. However, medicines aren't a cure for bed-wetting. The one kind of medicine that helps the bladder hold more urine is Imipramine (Tofranil). The other kind helps the kidneys make less urine and is called Desmopression acetate. This drug is administered as a nasal spray. These medicines may have side effects, such as dry mouth and flushing of the cheeks - consult your doctor before considering medical treatment for your child.

Outcomes of bedwetting

These children are embarrassed by their bed-wetting situation.  They often experience low self-esteem. These children's feelings or self esteem can be seriously injured by the attitudes of their parents, who may feel that their efforts to end the bed-wetting have failed. Parents also get affected by bedwetting, they may feel frustrated, angry and embarrassed about their children's bed-wetting condition.

Parents should understand that bed-wetting is not a mental problem. It doesn't happen because the child is too lazy to get out of bed to go to the bathroom. They should understand that children achieve bladder control at different ages. Parents can help their children reduce negative feelings about their bed-wetting condition and speed up the process of overcoming it, by offering positive support, understanding and encouragement.

Sources:

• Family doctor
• Child development info

Updated: 07 February 2012

 by Zanele Matshotyana