Most of the children develop night time bladder control after an age of 5 or 6 years. Nocturnal enuresis or bedwetting is the inability to control the pee while sleeping at night after the age when they should be able to control their bladder.
It is also known as involuntary urination.
Types of nocturnal enuresis
- Primary nocturnal enuresis- It is the most common form. It is defined as the involuntary and the recurrent passage of the urine, even after 5 years of age in a kid who have never attained regular night time dryness. It is further divided as
- Enuresis only at night time while sleeping.
- Enuresis with daytime wetting along with increased frequency to pass urine.
Causes of primary nocturnal enuresis in kids:
- Developmental delay– A child might not be able to sense whether his bladder is full because his nervous system is less mature.
- The small capacity of the bladder– Some children may have a small bladder.
- Very little Antidiuretic hormone– An Antidiuretic hormone released by the brain gives the signal to the kidney to decrease the amount of releasing water. This hormone usually rises at night, but in children with nocturnal enuresis this hormone may be not produced.
- Sound sleep– Your child might be a deep sleeper and may not wake up to pass urine. In this case with time, the sleep pattern matures and the problem of nocturnal enuresis in a kid is solved.
- Psycho-social factors– Nocturnal enuresis is common in children who live under stressful environment.
- Family history- In some cases, it has been found that nocturnal enuresis is inherited. If there is a history of bed wetting in one or both the parents then risk of nocturnal enuresis in kid increases.
- Secondary nocturnal enuresis in kids- This condition develops in a child after 6 months or years after learning to control bladder at night.
It may be due to underlying diseases such as:
- Urine infection.
- Stress
- Birth defects.
- Diabetes
Investigation:
Urine analysis and urine culture may be recommended to rule out the chances of urinary tract infection and diabetes.
Management of nocturnal enuresis in kids:
In most of the cases, nocturnal enuresis in kids is due to delay in development. This condition resolves with time without any treatment. In the case of secondary nocturnal enuresis treatment of the underlying diseases helps.
Below are the approaches to managing nocturnal enuresis:
- Encourage and praise your child, to wake up at night to pee.
- Moisture alarm that detects the child’s pant wetness and makes a sound that wakes up the child. This is usually helpful for children above 8 years of age.
- The doctor may also prescribe medicines such as Desmopressin and tricyclic antidepressants to increase the capacity of the bladder to hold urine or to decrease the amount of urine released by the kidney.
- If Nocturnal enuresis still persists after 12 years of age, it may be due to emotional stress and the child needs counselling by trained counselors.
Do remember nocturnal enuresis in kids is not intentional. Do not punish your child for it. Your love and support are important for the kid to get out of this problem.
