What Is Enuresis?
Enuresis is popularly referred to as bed-wetting. Bed-wetting or nocturnal Enuresis at night is the most encountered type of Enuresis. Wetting one’s self during the day is referred to as diurnal Enuresis. Some children experience Enuresis both at night and during the day, whereas others experience Enuresis either during the day or night.
This act may or may not be intentional. This condition is not diagnosed unless the child is 5 years or older.
Enuresis is a common problem among children. An estimate of 7% of boys and 3% of girls within the age of 5 have Enuresis. These estimated numbers drop to 3% of boys and 2% of girls by the age of 10. A good number of children outgrow this condition by the time they reach the adolescence stage, with about one percent of males and less than 1% of females still experiencing the condition at the age of 18.
Symptoms of Enuresis
- The major symptoms of Enuresis include:
- Wetting in the clothes
- Repeated bed-wetting
- Wetting at least twice a week for approximately three months
Causes of Enuresis
There are many factors that constitute the development of Enuresis.
Release of urine from the bladder may be caused by:
- Severe stress
- Urinary Tract
- A small bladder
- Developmental retardation that disturbs with toilet training
Either voluntary or intentional, Enuresis may be linked with other mental disorders, including behavioral or emotional disorders such as anxiety, depression, and more.
Enuresis can also run in families and their lineage; there’s a possibility for the disorder to be inherited by children from their parents, particularly from the father’s side. In addition, if the child was trained on the use of the toilet may influence the development of the disorder.
How Is Enuresis Diagnosed?
Medical history: This is the first thing done by the doctor before the conduction of a physical exam to cross-check any medical disorder that may have led to the release of urine, also known as incontinence.
Laboratory tests: Tests such as urinalysis and blood count maybe performed to measure the level of blood sugar in the body, hormones, and kidney function.
Physical conditions that could lead to incontinence include:
- Diabetes
- Infection
- Structural or functional defect causing a blockage in the urinary tract.
Enuresis may also be linked to certain medicines that can cause confusion or behavioral changes as side effects. If no physical cause is found, a diagnosis of Enuresis on the symptoms and current behaviors exhibited by the child will be the basis for the cause and then treatment of the condition.
How Is Enuresis Treated?
In mild cases of Enuresis, treatment may not be necessary since a greater percentage of children with this condition outgrow it (usually by the time they become teens or adolescence). Knowing when to start treatment can prove problematic as it is impossible to foretell the course of symptoms and when the child will outgrow the condition.
Some factors to be considered when deciding to begin treatment include:
The child’s self-esteem: If this condition is affecting the confidence level and self-esteem of the child.
Impairment in functioning: This condition may lead, for instance, lead to the child avoiding attending sleepovers with friends.
It is often recommended to begin therapy aimed at behavioral changes. Behavioral therapy is effective in more than 75% of patients diagnosed with this condition.
Behavioral therapy may include:
Alarms: Making use of an alarm system that rings when the bed gets wet can help the child learn to answer to feelings of urination at night. Currently, urine alarms are the only treatment that has a consistent and continuous improvement. The relapse rate of this condition is usually low, with an estimated rate of only 5% to 10%, so that once there’s an improvement on the child, it almost always stays improved.
Bladder Training:
This method employs regularly scheduled trips to the bathroom accurately timed at increasing intervals to aid an affected child become accustomed to “holding” urine for longer periods. This also aids in the stretching of the bladder size—a condition where a muscle in the bladder responds to the given exercise. Bladder training is most of the time used as part of an enuresis treatment program.
Rewards: This may include giving a series of rewards, be it little to the child as he/she improves with bladder control.
Medications:
They are available in the treatment of Enuresis but only used when this disorder affects the overall functioning of the body system. They are not to be taken by children under the age of 6 years.
Medications maybe used to reduce the amount of urine produced by the kidneys or to help increase the bladder’s capacity.
Common drugs used in the treatment of Enuresis include:
Desmopressin Acetate (DDAVP): This affects the production of urine by the kidney.
Imipramine: Also known as (Tofranil) is an antidepressant used in the treatment of Enuresis.
Whilst using drugs can be helpful in managing symptoms of Enuresis, the child could start bed-wetting again once he/she has stopped wetting. It is important to note that the side effects and cost need to be considered when choosing medications. The medications also may help in the improvement of the child’s functioning until behavioral treatments and therapy start to work.
Conclusively, not all cases of Enuresis can be prevented, most especially those related to a child’s anatomy problems but getting the child assessed by a pediatrician from the early onset of when symptoms become noticeable may help reduce the problems linked with the condition. Also, being optimistic and patient with a child during toilet training may help thwart the development of negative attitudes that may arise when using the toilet.
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