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Urination - bed wetting
DefinitionNighttime urinary incontinence in children over age 5 or 6.
Most children who wet the bed have at least one parent or first degree relative who also had a problem with bed wetting . Knowing this often helps the child feel less stressed about the situation.
Roughly 20% of children still wet their beds at age 5, only 5% do so by age 10, and 2% by age 15. Only 1 out of 100 childhood bed wetters continues to have a problem in adulthood.
Bed wetting is usually simply due to a delay in the maturation of the part of the nervous system that controls bladder function. It sometimes may be due to either psychological problems or medical disorders, such as a urinary tract infection , urinary tract abnormalities, or diabetes (diabetes mellitus or diabetes insipidus).
Do not worry about bed wetting in children before the age of 6, unless they were previously well toilet trained and the bed wetting is now a new symptom.
Do not punish a child who wets. This problem is not caused by laziness or rebelliousness. Shaming a child for wetting the bed can lead to poor self-esteem and feelings of low self-worth.
Reassure, encourage, and express confidence in the child.You can also have your child take an active part in cleaning up from the bed wetting (e.g., help with stripping the bed, putting the sheets in the laundry, etc.)
Withholding bedtime drinks may be helpful in some children because it decreases the volume of urine in the bladder, but this does not prevent the problem completely. Avoiding caffeine-containing drinks can also help decrease the amount of urine in the bladder ( caffeine increases urine production).
See your health care provider to consider the use of alarm systems (such as Wet-stop or Enuretone), or drugs like DDAVP nasal spray. The latter stops enuresis in 60-75% of children while taking the drug, but is not a permanent cure (once the medication is stopped, the bedwetting tends to recur).
Call your health care provider ifCall your doctor if there have been repeated episodes of bed wetting after the age of 6, if your child complains that it hurts when he/she urinates, if your child has been drinking excessive amounts of fluids, or if your child has been exhibiting strange behavioral changes (such as a normally outgoing child becoming withdrawn or a child suddenly behaving in a sexually suggestive manner).
A medical history will be obtained from the patient and the patient's parents (if the patient is a child).
Medical history questions documenting the bed wetting in detail may include:
A complete examination will be performed, with emphasis on the abdomen, rectum, and the urinary opening. The health care provider will discuss the options available for treatment.
After seeing your health care provider:
Update Date: 5/21/2002Elizabeth Hait, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT