about Bed Wetting
Bedwetting or enuresis is defined as the repeated, spontaneous voiding of urine during sleep in a child of five years or older. Children are said to have primary nocturnal enuresis if they have never managed to attain bladder control and secondary enuresis if incontinence recurs after six months of dry nights.
While it is not a serious medical disorder, bedwetting can have a considerable impact on the lives of the children, affecting their self-esteem and socialization, and it can also cause stress in their families. The keys to resolving the issue are good understanding and patience. The good news is that this problem often resolves itself over time.
Treatment for Bedwetting
The team of top Urologists in Dubai at Bizrahmed are skilled in helping children with both simple and complicated types of bedwetting. Bedwetting Treatment in Dubai will vary depending on how old the child is, the frequency of wetting, the impact on the family, and any symptoms that may be -associated with the bedwetting. Both pharmacological (medicines) and behavioural treatments exist. A combination of treatment modalities may be used if necessary to combat the problem. Unless an underlying medical cause is identified, primary and secondary bedwetting are treated the same way. Our expert medical team at Bizrahmed will also be able to advise on what parents can do to reduce the stress related to nocturnal enuresis and practical measures you can take to manage the condition. It is important to keep in mind that bedwetting is not the fault of the child or the parent. No one should feel embarrassed or ashamed of the situation.
Causes of Bedwetting
Most children do not have a disease process behind their bedwetting. However, formal studies had shown an increased risk of bedwetting if one, or particularly both, parents wet their beds when they were children. Primary nocturnal enuresis is caused by a disparity between bladder capacity and urine production and the failure of the child to wake up in response to a full bladder. The less-common secondary enuresis develops due to psychological or behavioural problems.
As we can see then, bedwetting is a complex phenomenon, and physical and psychological causes can include:
No decrease in urine production at night: The body releases vasopressin at night, and this hormone reduces the amount of urine the kidneys make. It is believed that some children’s bodies do not create enough of this hormone, leading to bedwetting.
Diminished bladder capacity: Bedwetting children often have a smaller bladder capacity than other children.
Constipation: Parents are often surprised to find that when constipation is treated, bedwetting stops. A build-up of stool in the rectum pushes against the bladder and can affect it in two ways. Firstly, it can lower the bladder’s capacity and affect how well it empties on urination. Secondly, the pressure can ‘confuse’ the nerve signals, creating the impression that the bladder is full.
Arousal disorder refers to an inability to respond to the body’s signals that it is time to urinate; instead, the child sleeps through them.
Psychological factors: Following a period of stress or psychological problems or trauma, a child may develop secondary nocturnal enuresis or a return of bedwetting they had outgrown.
Depending on the circumstances, your doctor may recommend the following to identify any underlying cause of bed-wetting and help determine treatment.
- Physical exam
- Discussion of symptoms, fluid intake, family history, bowel and bladder habits, and problems associated with bed-wetting.
- Urine tests to check for signs of an infection or diabetes.
- X-rays or other imaging tests of the kidneys or bladder to look at the structure of the urinary tract.
- Other types of urinary tract tests or assessments, as needed.
When does Bedwetting Stop?
Most children (85%) stop wetting their beds from the age of three and before the age of six. This happens for two reasons. First, the bladder will send a signal to the brain saying that it is filling up with urine, and the brain will return a signal telling the bladder to relax so it can hold more urine. Second, if the bladder cannot hold all of the urine overnight, it will keep sending signals to the brain until the child wakes up to go washroom. Regarding the remaining children, bed-wetting will occur if there is a delay in learning one or both of these skills.
At what age should you worry?
Firstly, if your child has passed the age of five and still has permanent or frequent bedwetting and is bothered or embarrassed by the condition, it is worth visiting a urologist.
It is essential to recognize that the process of urination is not under voluntary control, and parents should reassure the child that the bedwetting is not his or her fault. The communication signals in the nerve and muscle groups linking the brain to the bladder are very complicated, which explains why bladder control improves with age as the child develops. Secondly, if the child has reached school-age with enuresis, this usually justifies prompt intervention, mainly if enuresis is frequent and the child is depressed or distressed.
Lifestyle and Home Remedies
Here are changes you can make at home that may help:
- Limit fluids in the evening. It’s essential to get enough fluids, so there’s no need to limit how much your child drinks in a day. However, encourage drinking liquids in the morning and early afternoon, reducing thirst in the evening.
- Avoid beverages and foods with caffeine. Beverages with caffeine are discouraged for children at any time of day.
- Encourage double voiding before bed. Double voiding is urinating at the beginning of the bedtime routine and then again just before falling asleep.
- Encourage regular toilet use throughout the day. During the day and evening, suggest that your child urinate every two hours or so, or at least often enough to avoid a feeling of urgency.
- Prevent rashes. To prevent a rash caused by wet underwear, help your child rinse his or her bottom and genital area every morning.
Coping and Support
Children don’t wet the bed to irritate their parents. Be patient as you and your child work through the problem together. Effective Bedwetting treatment in Dubai may include several strategies and may take time to be successful.
- Be sensitive to your child’s feelings. If your child is stressed or anxious, encourage him or her to express those feelings. Offer support and encouragement. When your child feels calm and secure, bed-wetting may become less problematic. If needed, talk to your paediatrician about additional strategies for dealing with stress.
- Plan for easy cleanup. Cover your child’s mattress with a plastic cover. Use thick, absorbent underwear at night to help contain the urine. Keep extra bedding and pyjamas handy. However, avoid the long-term use of diapers or disposable pull-up underwear.
- Enlist your child’s help. If age-appropriate, consider asking your child to rinse his or her wet underwear and pyjamas or place these items in a specific container for washing. Taking responsibility for bed-wetting may help your child feel more control over the situation.
- Celebrate effort. Bed-wetting is involuntary, so it does not make sense to punish or tease your child for wetting the bed. Also, discourage siblings from teasing the child who wets the bed. Instead, praise your child for following the bedtime routine and helping clean up after accidents. Try rewarding if you think this might help to motivate your child.
To combat bed-wetting, doctors suggest:
- Shift times for drinking.
- Schedule bathroom breaks.
- Eliminate bladder irritants.
- Avoid thirst overload.
- Consider if constipation is a factor.
- Don't wake children up to urinate.
- An earlier bedtime.
If your child is wetting the bed at any age and seems to have other symptoms such as diabetes, a urinary tract infection or stress of any kind, then make an appointment with the best urologist in Dubai to find the underlying cause affecting your child.
No medication cures enuresis or bedwetting - they only treat symptoms. When the drug is stopped, the enuresis will usually return unless the child has naturally outgrown it.
Nocturnal enuresis or bedwetting is the involuntary release of urine during sleep. Bedwetting can be a symptom of bladder control problems like incontinence or overactive bladder or more severe structural issues, like an enlarged prostate or bladder cancer.
Nearly all bedwetting problems can be cured with single or combination therapy. Some people do however, will need long-term drug therapy.
Desmopressin (DDAVP) and imipramine (Tofranil) are the primary drugs used in the treatment of nocturnal enuresis or Bedwetting. Pharmacologic treatment is not recommended for children under six years of age.
Typically, a child becomes toilet trained between ages 2 and 4. But some will not be able to stay dry through the night until they are older. By age 5 or 6, 85% of children can stay dry, but some children still wet the bed from time to time until age 10 or 12.