BEDWETTING
Bedwetting is an unintentional passage of urine during sleep after the age at which bladder control is reasonably expected.
- In boys, bladder control is usually achieved by the ages of 4-7 and most girls achieve bladder control by ages 4-7.
- By 10 years old, 95% of children are dry at night.
- Bedwetting in children is often just a normal part of a child’s development.
- Enuresis is the medical term for bedwetting and it is one of the most prevalent and frustrating disorders of childhood.
- Though bedwetting is generally thought of as a childhood problem, it can occur in people of all ages and both sexes.
- Bedwetting that persists later in childhood and even into adulthood may require further investigation.
- Bedwetting in adult mainly affects males and occurs in around 2% of the population. The condition is not just a devastatingly embarrassing condition, it is often a sign of other medical troubles.
- An adult that frequently bed wet should discuss symptoms with their primary care provider who helps to find the cause of the problem.
- Bedwetting can be classified into primary or secondary
- Primary bedwetting refers to the bedwetting that persists and has been ongoing since early childhood. A child with primary bedwetting has never attained bladder control during the night.
- Secondary bedwetting refers to a bedwetting that occurs when a child starts to wet the bed after an extended period of dryness at night. This may be associated with an underlying medical condition or emotional problem.
CAUSES
No one knows for sure what causes bedwetting but various factors may play a role:
- Physical abnormalities such as a small bladder
- Urinary tract infection
- Diabetes
- Kidney disease
- Chronic constipation
- Sleep apnea
- Caffeine
- Kidney disease
- Anti-diuretic hormone imbalance
- Excessive fluid intake
- Genetics
- Neurological-developmental delay
- Attention deficit hyperactivity disorder
- Psychological issues such as the death in the family, extreme bullying or sexual abuse
- Alcohol consumption
- Prostate cancer
- Bladder cancer
- Stress, anxiety or fear
- Enlarged prostate gland
SYMPTOMS
- Bed wetting at night. This is the most common symptom. Most people tend to have no other symptoms other than that.
DIAGNOSIS AND TREATMENT
The doctor may recommend the following to identify an underlying cause of bedwetting:
- Perform a physical test
- Discuss symptoms, family history, bowel and bladder habits and any problems associated with bedwetting.
- Urine test for infections
- Imaging tests of the bladder and kidney to visualize the structure of the bladder
- Neurological examination
IN ADULTS, in addition to diagnosis,
To help the doctor better determine the cause, it is suggested that you keep track of important information about bedwetting, such as:
- When an accident occurs (time of the day or night}
- Amount of urine voided
- Daily drinking patterns (do you drink more fluids in the later afternoon/evening
- Types of fluid ingested whether they are sugary, caffeinated, alcoholic or carbonated)
- The number of wet nights vs. dry nights
- Recurrent urinary tract infection
- Any other symptoms associated with bedwetting such as night sweat is noted
- Nature of the urinary stream (is it strong and steady or weak and dribbling)
TREATMENT
Children usually outgrow bedwetting on their own.
Lifestyle changes such as avoiding caffeine entirely and limiting the intake of fluid in the evening might help
If detected, underlying health condition such as constipation and sleep apnea should be addressed before other treatment.
The underlying emotional issue should be also be treated
Treatment options may include moisture alarms that sounds just as the child begins to urinate, the child then wakes up, stop the urine stream and get to the toilet. If the child is a heavy sleeper, another person may be needed to listen for the alarm and wake the child.
Medications such as darifenacin prescribed by the doctor may be used to stop bedwetting for a short period.
Absorbent underwear may be worn during the night. This can reduce embarrassment for bedwetters both young and old. The products are known as diapers when used for younger children and briefs when marketed for older children and adults.