(1) What is enuresis in children? Childhood enuresis is a condition in which a child is unable to control daytime or nighttime urination and wets his or her pants or bed even after the age of 5. However, parents must be aware that this age of 5 is not absolute. For example, if a child has not wet the bed at all for more than six months before the age of 5, and then bedwetting occurs again, it is highly likely that the child’s enuresis is pathological, regardless of whether the child is more than 5 years old. This is the same as a child who has learned to walk and then can’t walk anymore, there must be an underlying cause for the loss of an acquired ability. (2) What are the signs (symptoms) for identifying enuresis? Some children wet the bed every day, while others wet only 1-2 times a week; some children urinate a lot, while others wet only a little; some children remain asleep after wetting the bed, while others wake up after wetting; and some children not only wet the bed at night, but also wet their pants during the day. In enuresis, some children have constipation and fecal emission. Most children with enuresis drink less water and urinate less during the day, while they drink more water and urinate more at night. Notably, more of the children with enuresis have inattention, sleep disorders, poor temperament, introversion, or hyperactivity with poor self-control, learning disabilities, and obesity. In addition, a higher percentage of children who sleep at night with snoring have enuresis. All of these symptoms mentioned above may be related to enuresis, and parents must pay attention to them. (3) What are the main causes of enuresis in children? Parents should not be overly nervous about their child’s enuresis because the majority (over 90%) of enuresis in children is functional, i.e. due to genetic factors combined with improper bowel training of the child. Generally speaking, although this type of enuresis is long and stubborn, it can be improved or cured with the right treatment and persistence. Only a small percentage of enuresis is caused by organic diseases of the nervous system, endocrine system or urinary system, such as brain tumors, epilepsy, diabetes, uremia, urinary tract infections, urinary tract malformations, etc. This type of enuresis is secondary to enuresis. If these causes really exist, we can find them out by taking the child to a specialized clinic for enuresis. (4) How can I tell if I need to see a doctor or take care of myself? ①What are the cases that do not require excessive stress and can be taken care of on their own for the time being? What can parents do to correct or improve these conditions in their children? Most parents are very concerned and nervous about their child’s bedwetting. It is true that prolonged and persistent bedwetting has a negative impact on the child and the whole family, reducing the quality of life for the family and hindering the child’s healthy physical and mental development. However, all things are not created equal, and in some cases, immediate medical attention is not necessary, and parents may wish to do something on their own to solve the problem. The parent at the beginning of this article, for example, is unlikely to have secondary enuresis caused by organic disease because the child is less than 5 years old and the bedwetting has been present since the child was a child. In this case, parents should not scold and punish the child for this matter, and should adjust the child’s water intake structure, i.e., give the child more water during the day and limit the water intake at night. Also, put your child to bed earlier at night to ensure adequate sleep and prevent sleep deprivation (literature reports that sleep deprivation can worsen enuresis). Give your child some responsibility training, such as having him or her help clean the bed and telling him or her that it is his or her responsibility to keep the bed clean. All of this helps the child develop nocturnal urinary control, i.e., the ability to wake up at night to urinate on his or her own, and if this ability reaches maturity, the problem is solved. Only after the age of 5 is enuresis considered a disease. ②What are the conditions (frequency of urine loss during the day and night, how long the condition lasts, etc.) that should be seen by a doctor? What kind of clinic do I usually see? Generally, if a child is over the age of 5 and still wets the bed, he or she should seek medical attention because the longer the enuresis lasts, the more psychological damage it can cause to children, especially older children. If a child’s enuresis occurs suddenly at an older age, it is even more important to seek immediate medical attention because this condition is often caused by lesions of the brain, spinal cord, kidneys, bladder or endocrine system. In addition, special attention should be paid to the symptoms accompanying enuresis, such as frequent and painful urination, excessive drinking, thirst, weight loss, headache, vomiting, convulsions, abdominal pain, back pain, etc. This is a warning of the presence of other serious diseases and should be seen by a doctor quickly. For children with enuresis, it is best for parents to take their children to a tertiary children’s hospital specializing in enuresis, but if the accompanying symptoms mentioned above occur, they can also take their children to a neurologist, nephrologist or endocrinologist. ③How can parents tell the doctor about their child’s condition (what is the key information to tell the doctor in time) when they take their child to the doctor? Can it be cured? Will it leave sequelae? Parents who are conscious of collecting information about their child’s condition can be very helpful to the doctor in diagnosis and treatment. Parents need to pay attention to the following aspects: when the enuresis started, whether the enuresis stops completely after six months, how often the enuresis occurs, whether the enuresis is accompanied by wetting of pants during the day, how much the enuresis is, whether the enuresis is in the first half of the night or in the second half of the night, whether there are other accompanying symptoms, whether the child can wake up immediately after the enuresis, and so on. In addition, it is important to fully understand whether there are cases of enuresis in the family so that the doctor can make an accurate judgment. In the case of secondary enuresis, if the organic cause of the secondary enuresis is resolved, the enuresis will often improve. For example, if a brain tumor causes enuresis in children, the enuresis may disappear after the tumor is removed. Primary (functional) enuresis has a longer course, but if the right experienced enuresis specialist can develop a targeted treatment strategy based on a thorough evaluation, it usually resolves gradually and does not leave major sequelae. However, it is thought that nocturnal polyuria (i.e., the need to get up several times at night to go to the toilet to urinate, which affects one’s sleep quality), which is common in adults, may be a residual symptom of childhood enuresis. (5) How can parents be effectively involved in the treatment of their child’s urinary disorder in cases that require medical attention? In the treatment of enuresis, active parental cooperation is the key to successful treatment. For the vast majority of functional enuresis, it is not just medication that is needed, but also extensive behavioral training. The acquisition of nocturnal urinary control skills is like a person going from not knowing how to swim to learning how to swim; a lot of training must be done according to a scientific approach. Parents should build confidence with their children, constantly encourage them, and follow the doctor’s instructions to overcome enuresis as an obstacle in life step by step by using scientific functional training methods and combining them with medication. (6) Childhood enuresis causes a lot of trouble for both the child’s growth and the parents, can it be prevented? There is a genetic basis for enuresis in children, so children with a family history are particularly susceptible to enuresis. However, the occurrence and development of enuresis is also influenced by environmental factors, especially early childhood voiding training. Prevention of enuresis in children should begin in infancy. According to the latest medical research in this field, the following points can be done to prevent enuresis in children: 1. let children sleep alone in a small bed from an early age and try not to sleep in the same bed with adults; 2. encourage children to go to the toilet when they have to urinate after the age of one; 3. let children go to bed early and wake up early to get enough sleep and ensure the quality of sleep; 4. do not wake children frequently at night to prevent sleep deprivation because There are many studies that show that sleep deprivation is the cause of enuresis; 5. Give the child plenty of water during the day and limit the amount of water drunk at night; 6. Give the child adequate verbal and material rewards for each time he or she wakes up at night to urinate on his or her own.