Enuresis In Children – Causes And Treatment

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Life is cyclic. What you feel frustrated with as a mother is most likely what frustrated your parents too! But that knowledge does not make parenthood any easier.

Among the many struggles you’ll face as a mother, Enuresis may be the most frustrating one. Not just messy, but it can also bring the mood down in many households.

But you cannot simply wish a problem away. You need to deal with it. Not just for yourself, but for your kid too!

So, here’s all you need to know about Enuresis and ways to deal with it.

Kinds Of Enuresis:

There are two types of Enuresis:

  • Primary Nocturnal Enuresis (PNE): Some children never manage to develop nighttime bladder control. These kids are said to have Primary enuresis. Most kids suffer from this problem. There is no particular cause that explains this kind of enuresis.
  • Secondary Nocturnal Enuresis: Not as common as PNE, some kids suddenly develop an inability to control their bladder. In most cases, this is due to stress in the family. 

Causes Of Enuresis In Children?

There are several factors that may cause enuresis in children. Here are the major ones:

  • A smaller than average bladder (1)
  • Chronic constipation (2)
  • Severe stress (3)
  • Delay in the development of the Central Nervous System (4)
  • Family history (5)
  • Abnormal Sleep Structure (6)

It is important to remember that enuresis is a common childhood problem. So, no matter the cause, there is a big chance that your kid too may have enuresis. But that is not reason enough to panic!

Symptoms Of Enuresis In Children:

The symptoms of enuresis include:

  • Repeated bed-wetting
  • Wetting the clothes
  • Regular wetting at least twice a week over a period of three months 

[ Read:Bed Wetting In Children ]

How Is Enuresis Diagnosed?

If your child has a history of bedwetting and is over five years of age, you can take him to the doctor for evaluation. Some of the tests, your doctor may suggest for diagnosing the condition are the following:

  • Checking blood pressure
  • Examining external genitalia
  • Checking the renal and abdominal areas
  • Neurologic examination
  • Assessment of the anal “wink.”
  • Inspection of the lumbosacral spine
  • Urinalysis
  • Ultrasound scan of the bladder and kidneys
  • Voiding cystourethrogram
  • An MRI of the spine
  • Urodynamic studies and cystoscopy

Once your doctor figures out the exact cause for enuresis in your child, he’ll suggest the apt treatment.

Treatment Of Enuresis In Children?

Most mild cases of enuresis do not require medical intervention. Fortunately, most kids outgrow this bedwetting phase by the time they reach their teens.

But even when they need treatment, let it start with behavioral modification. Some of the tricks you can use to nudge your kid to overcome enuresis can include:

1. Alarms:

You can install an alarm system that rings when the bed is wet. A snazzy trick, it can help your kid understand and respond to bladder sensations at night. These alarms have been in use for over fifty years now. They are still the best treatment option for enuresis (7).

[ Read: Best Bed-Wetting Alarms ]

2. Bladder Training:

Don’t worry, bladder training is not as hard as you think it is! But a little effort on your part can pay rich dividends. All you need to do is set up a schedule and take your kid to the bathroom at regular intervals. The practice will teach your little one how to hold urine for longer duration. It is a great exercise for the bladder muscles. Bladder training is one of the primary tools in treating enuresis.

3. Rewards:

When it comes to young kids, a reward is a great motivation to master bladder control. You can use small toys or other rewards to help your kid along (8).

Apart from behavioral modification, enuresis may also require medication. But medication may not be an option if your child is younger than six years.

1. Desmopressin Acetate:

Your doctor may prescribe medication to reduce the amount of urine in the kidneys. The use of drugs like Desmopressin acetate (DDAVP), help reduce the incidents of bedwetting. But these medications can also cause some side effects, and you should give these drugs to your child only after consulting a doctor first (9).

2. Anticholinergic Agents:

Drugs such as oxybutynin chloride and tolterodine are great options for children with an overactive bladder (10). These drugs work best in tandem with Desmopressin acetate.

3. Imipramine:

Though not as effective as the other drugs mentioned here, Imipramine is still a great choice (11). But be careful! The World Health Organization does not recommend this drug for the treatment of enuresis. Strictly use this drug after consulting a pediatrician.

Drugs can be a great short-term solution for managing enuresis in kids. But in most cases, once your child stops using the medication, bedwetting may recur. It is also important to consider the cost and side effects of medication for children.

Management Of Nocturnal Enuresis In Children?

Here are some easy tips for you to manage the condition at home (12):

  • Have patience and don’t lose your temper. Scarring your child for life over a few wet sheets is just not worth it.
  • Do not discuss your baby’s bedwetting issues in front of outsiders. Respect your kid’s right to privacy.
  • Let your kid change his wet pajamas and bedding himself. But don’t turn it into a punishment.
  • If you have a young kid, you may need to use pull-ups over the underwear.
  • Give your kid plenty of fluid early in the day.
  • Make sure your kid makes a trip to the bathroom to empty his bladder before bed.
  • Make sure your kid gets sufficient sleep.
  • Wake your kid up in the middle of the night and make him go to the bathroom.
  • You can also try hypnosis to help your kid beat enuresis. Though not as effective as medication, hypnosis can help some children (13). 

How To Prevent Enuresis?

Unfortunately, unless your kid’s problem arises from stress or behavioral issues, there’s not much you can do to prevent enuresis. If your kid suffers from anatomical issues, he may need longer treatment plans. The best you can do is to seek medical help as soon as you notice the symptoms of enuresis.

Enuresis can take a toll on your child’s self-esteem. Remember, no matter how cumbersome it seems today, this is just another phase. It will pass. Don’t let enuresis sap your kid of his confidence!

Did your child suffer from enuresis? How did you help him overcome it? Share your experience and advice with us.

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