What Is Nocturnal Enuresis? | All About Enuresis

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What Is Nocturnal Enuresis?

Bedwetting, also called nocturnal enuresis, is the emptying of the bladder when the child is asleep. This can happen multiple times or every night.

Bedwetting is common. One in five children in Australia wet the bed. Bedwetting can occur genetically in families and is more common in boys than girls before the age of nine. This can be annoying for the child and a stressful one for the whole family. The good news is that you can get help.

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Types of enuresis

Enuresis may be of the following types:

Primary enuresis: It refers to the condition in which children have never been successfully training to control urination. There may be a detain in the maturation of sphincter control.

Secondary enuresis: It refers to the condition in which children have successfully trained but revert to bedwetting in response to some stress. It may be due to parent-child  adjustment.

Another classification ng is base on the time of bedwetting:

Nocturnal enuresis:  It means bedwetting during the night.

Diurnal enuresis: It means bedwetting during day time.

Mixed enuresis: It includes a combination of both nocturnal and diurnal type.

 

Causes of enuresis

Inappropriate toilet training: The age at which toilet training is starting has an essential impact on the child. If toilet training begins very early, it produces stress on the child.

Neurological developmental delay: There is detain development in the ability to stay dry. Bedwetting may be due to a delay in the nervous system’s ability to process a full bladder feeling. 

Genetics: Children whose parents were not wetting the bed have only a 15% incidence of bedwetting. When mother and father were bedwetters, the rates jump to 44% and 77%, respectively.

Bedwetting is associated with genes on chromosomes 13q and 12q.

Emotional factors: Emotional and psychological disturbance due to death in the family, sexual abuse, extreme bullying, severe punishment or scolding, jealousy feeling or sibling rivalry, and sense of being rejected create internal tension in the child, leading to secondary enuresis.

Organic causes

Enuresis may occur due to;      

  • Anatomical defect of urinary tract and bladder
  • Diabetes insipidus
  • Urinary tract infection 

Factors associated with enuresis

  • Faulty training
  • Emotional disturbances 
  • Physical disease and anatomic defects.

I also wrote a article on: Factors Affecting Growth and Developments of Child

Diagnostic evaluation

  • Lab test include
  • Diabetes test
  • Kidney function test
  • Urine analysis
  • Test for urinary tract infection.

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Management of enuresis

  • It is essential to assess the child’s home conditions, his/her socioeconomic status, and family conditions. 
  • Explore the child-parent relationship. A child’s relationship with playmates, teachers, and siblings is also evaluating.
  • Reassure the child and parents. 
  • Try to build the child’s self-confidence.
  • Should explain to parents about the factors related to bedwetting.
  • Parents should be asked not to scold, threaten, or punish the child. Parents are advised not to nag, criticize, or reprimand the child for bedwetting.
  • The child should not give any liquids like tea or milk after 5 pm.
  • The child should habitually make pass urine before going to bed.
  • The parents should arouse the child after 2-3 hours of sleep and persuade him to walk unaided to the toilet to empty the bladder.
  • They have trained the child to hold urine for a longer time. May fix this by making the child drink a large quantity of water during the day and persuading him to delay emptying the bladder as long as possible.

Bedwetting alarms

  • Physicians frequently suggest bedwetting alarms, which produce a loud tone on sensing moisture. It helps the child to wake at the sensation of a full bladder.

Medications

  • In very resistant cases, Tricyclic Antidepressants like amitriptyline, imipramine, and nortriptyline are given orally at night for two months. 
  • Desmopressin, a synthetic replacement for antidiuretic hormone (ADH), is also offered as it reduces urine production during sleep.

Conclusion

  • Bedwetting is common for children, and they usually grow out of it naturally. Most children start getting into bed after the age of 6. At this age, bladder control is stronger and more developed. Lifestyle changes, and talk to your doctor and proper treatment.

Here are a few more article which will help you:

Do you have any questions about choosing the best treatment for early and long lasting recovery for your child? Ask in the comments!

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