Most doctors consider a bedwetting child to be any girl older then four and any boy over age five who wet the bed. Bedwetting generally declines with age. About 10 percent of all six years olds and about 3 percent of all 14 year olds wet the bed. In a very small number of cases, bedwetting can continue into adulthood. Bedwetting (enuresis) is considered to be PRIMARY if the child has never been dry at night or only is occasionally dry at night. SECONDARY enuresis refers to bedwetting episodes that occur after a child has been dry at night for a considerable length of time.
Primary Enuresis: This is the main topic for this page and will be considered in depth. When the problem continues into the school years, appropriate intervention can usually correct the problem. This page will review the causes and treatments for Primary Enuresis.
SECONDARY ENURESIS: Children who have been dry at night for a considerable period of time may have occasional episodes of bedwetting. These are usually related to stresses in a child’s life and clear up on their own. Three of the more common events likely to cause bedwetting in young children are: hospitalization, entering school and the birth of a sibling. Children can also experience stress from such family problems as divorce, parental alcoholism, financial pressure as well as abuse and neglect. If the symptoms persist, you should consult your child’s doctor because the cause may be a physical problem which may require diagnosis and treatment.
CHRONIC BED-WETTING
Cause: Chronic bed-wetting is thought to be related to a physically and or neurologically immature bladder and or a deep sleeping pattern. Apparently these children often sleep so deeply that they are not aware of the message the bladder sends to the brain saying it is full. It is presumed that bed-wetting is an inherited condition. Usually a parent , aunt, uncle, grandparent or other family members well have had the condition. Also, children with attention deficit disorder, learning disabilities or allergies seem to be more likely to be bed-wetters than children in the general population.
Effect of Bed-wetting on the Child and Family: By the first grade, most children are embarrassed by their bed-wetting condition. They tend to withdraw from social activities that require sleeping outside their home. They also often suffer from low self-image. These children’s feelings can be greatly affected by the attitudes of their parents, who may feel that their efforts to end the bed-wetting have failed. Parents may also feel frustrated, angry and embarrassed about their children’s bed-wetting condition. Parents can help their children reduce negative feelings about their bedwetting condition and speed up the process of overcoming it, by offering positive support, understanding and encouragement.
TREATMENT: First of all, almost all children outgrow their bed-wetting habit. As children mature, their muscles become stronger and their bladder capacity increases. They tend to sleep less deeply and to become more sensitive to messages the bladder sends to the brain. There are two approaches to treatment: Medical or Behavioral. The medical treatment usually consists of the use of one or two drugs. Imipramine is a tricyclic antidepressant. It is thought to either improve the child’s sleeping pattern to improve the functioning of the smooth muscles found in the bladder. This medication brings some improvement to about 30 percent of the children who have tried it. Often, the symptoms return when the medication is discontinued. The drug can cause serous side effects and needs to be closely monitored by the prescribing physician. Desmpressin acetate is a synthetic form of the antidiuretic hormone and is administered as a nasal spray. It helps the child’s body make less urine, and thus lessens the risk that the child’s bladder will overfill during sleep. The medication often works quickly. However, the condition may return after discontinuation of it’s use. While this medication is much safer than Imipramine, it still can cause some side effects.
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