What is urinary incontinence (enuresis)?
Urinary incontinence (enuresis) is the medical term for bedwetting. Urinary incontinence is when a child who is at an age when he or she would otherwise be able to control his or her bladder has accidental or deliberate urination. Girls usually gain bladder control earlier than boys. Incontinence may be diagnosed in girls over the age of 5 and in boys over the age of 6 who still have problems with urinary control. There are different types of bedwetting that may occur, including the following.
Daytime enuresis: wetting of pants during the day.
Nocturnal enuresis: wetting of the pants at night.
Primary enuresis: This occurs when the child has never fully mastered toilet training.
Secondary enuresis: This occurs when the child does have a period of not wetting pants, but then returns to a period of incontinence.
Prevention and risk assessment: Are there any key facts about urinary incontinence?
According to the American Academy of Pediatrics.
Bedwetting affects 20% of 5-year-olds, 10% of 6-year-olds, and 3% of 12-year-olds.
Nocturnal enuresis is twice as likely to occur in boys than in girls.
The majority of children who urinate wet their pants at night.
Primary enuresis is the most common form of urinary incontinence in children.
What causes urinary incontinence?
Many factors may be involved and there are many theories to explain why children wet their pants. The following is a list of possible causes for this problem.
Poor toilet training delayed ability to preserve urine (this may be a factor until about five years of age).
Small bladder.
Poor sleep habits or presence of sleep disorders.
Problems with the normal functioning of hormones that help regulate urination.
Most children who wet the bed have at least one parent or close relative who also suffered from bedwetting as a child.
Medications that affect sleep.
Diagnosis: How is urinary incontinence diagnosed?
The diagnosis of incontinence (urine loss) is usually based on a complete medical history and your child’s physical examination. In addition to talking with you and your child, your child’s doctor may perform the following tests to help rule out other causes of wetting pants.
Urinalysis (to make sure there is no underlying infection or disease, such as diabetes).
A blood pressure measurement.
Blood tests.
Treatment: What is the treatment for urinary incontinence (loss of urine)?
Your child’s doctor will determine the specific treatment for enuresis based on
Your child’s age, overall health status and medical history.
The extent of the disorder.
Your child’s tolerance for specific medications, procedures or treatments.
Expectations about the course of the condition.
Your opinion or preference.
Important notes before starting treatment.
The child is completely blameless and should never be punished. The child is not in control of wetting his or her pants.
According to the American Institute of Diabetes and Digestive and Kidney Diseases, the natural disappearance rate of enuresis in affected children is about 15% per year by age 5 and beyond.
Treatment may include
Positive reinforcement for the child (such as using a sticker chart to keep track of nights without wet pants)
Use of nighttime alarms, which help tell your child when wetting occurs
Medications, prescribed by your child’s doctor (to help control wetting)
Bladder training to help increase bladder capacity and also improve the child’s ability to recognize when they have to go to urinate (this is done by having the child wait as long as possible during the day to urinate and allow the bladder to fill) Reducing water intake at night (if the child thinks it helps, the American Academy of Pediatrics recommends this method), avoiding caffeine In addition, counseling of the child and their family may help to Identify some of the stressors the child may have.