Urinary incontinence (enuresis) is the medical term for bedwetting. Incontinence is accidental or intentional urination in children who are at an age where they should be able to have control of their bladders. Girls usually obtain bladder control before boys do. Incontinence may be diagnosed in girls over the age of five and in boys over the age of six who are still having urinary control problems. There are different types of bedwetting that may occur, including the following:
diurnal enuresis - wetting during the day.
nocturnal enuresis - wetting during the night.
primary enuresis - occurs when the child has never fully mastered toilet-training.
secondary enuresis - occurs when the child did have a period of dryness, but then returned to having periods of incontinence.
Nocturnal enuresis affects 5 million to 7 million children in the US.
Nocturnal enuresis occurs three times more frequently in boys than in girls.
Of the children with bedwetting, most have wetting at night.
Primary enuresis is the most common form of urinary incontinence among children.
There are many factors that may be involved, and many theories that are given for why children wet. The following is a list of some of the possible reasons for the problem:
delay of the ability to hold urine (this may be a factor up to about the age of five)
poor sleep habits or the presence of a sleep disorder
a problem with the proper functioning of hormones that help to regulate urination
Urinary incontinence (enuresis) is usually diagnosed based on a complete medical history and physical examination of your child. In addition to talking with you and the child, your child's physician may perform the following to help rule out other causes for the wetting:
urine tests (to make sure there is not an underlying infection, or condition such as diabetes)
blood pressure measurement
Specific treatment for enuresis will be determined by your child's physician based on:
your child's age, overall health, and medical history
extent of the condition
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Prior to starting treatment, it is important to know that:
Enuresis at night without daytime symptoms occurs in up to 20 percent of children at the age of five.
The child is not at fault and should not be punished. The child cannot control the wetting.
Enuresis usually goes away on its own in about 15 percent of affected children each year.
Treatment may include:
positive reinforcement of the child (i.e., the use of sticker charts for dry nights)
use of night-time alarms to help tell the child when wetting is occurring
medications, as prescribed by your child's physician (to help control the wetting)
bladder training to help increase the bladder size and the child's ability to know when they have to urinate (this is done by having the child wait as long as possible during the day to urinate and let the bladder get full)
In addition, counseling of the child and family may help to determine any stress the child may be under. Strategies for reducing your child's stress will be discussed.
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