What is enuresis (bedwetting)?
Enuresis is an inability to control urine that may occur during the day or night. This
is usually not a cause of concern until the child is past the age of five.
Almost 100% of children will be dry by the age of 15 years. Most children seem
to wet more at night. This may be related to the way the human develops self
control of the urinary system and the bowels. It is felt by some that enuresis
may be delay in the development of control and that no other abnormality exists
in the child. Sometimes children may start to be wet after they have been dry
for some time. This is usually related to periods of stress. It is well known
that enuresis runs in families. The children of patients who were bedwetters
have a higher incidence of bedwetting. Most urologists feel that tests should
be limited on children who present with enuresis. Extensive testing is usually
not warranted, however a good history and physical exam and performance of a
urinalysis and culture is necessary to rule out other potential diagnoses. In
those patients where there is the concern of a urinary tract abnormality,
ultrasound may be obtained.
Usually there is no cause that can be directly treated. Some
families might elect not to treat the child as some of the medications may have
side effects. Some medications may be utilized to relax the muscles of the
bladder and to attempt to increase the volume that the bladder can store. Newer
agents decrease the production of urine at night. A motivated child is the key
to the success of any treatment modality. Rewarding success and increasing the
child's responsibility work well. Conditioning is the most effective therapy.
The use of alarms appear to work well. Modern alarms are safe and inexpensive.