Download ENURESIS Nocturnal - Dayton Children`s Hospital

NOCTURNAL ENURESIS
Nocturnal Enuresis (Bedwetting)
This form explains about Nocturnal Enuresis and what to expect if your child comes to Dayton Children’s,
Nephrology Department for evaluation and / or treatment.
What is Nocturnal Enuresis?
Nocturnal enuresis is a medical name for nighttime bedwetting.
Facts about nocturnal enuresis:
• 15 to 20% of 5-year-olds, 3% of 10-year-olds and 1% of 14-year-olds wet the bed.
• It tends to be more common in boys.
• It is NORMAL for children under the age of seven to wet the bed.
What causes enuresis?
Enuresis can be caused by various situations and conditions. There are many factors that may be involved, and
many theories have been suggested to explain it. Most of the times multiple factors and not just one are involved in
the cause of enuresis. Possible causes of nocturnal enuresis include hormonal factors, dietary factors, the effect of
certain medications, timing of daytime fluid intake, and emotional factors. Most importantly in many cases is a
delay in the normal maturational process.
Some children who have nocturnal enuresis will also have daytime urine accidents. Causes for this may include
urinary tract infections, abnormalities of the urinary tract, problems with bathroom habits, or problems with the
nerve control of the bladder
Often, nocturnal enuresis is found to run in families.
Family history is a factor:
• Both parents = 75% risk
• One parent = 45% risk
• Neither parent = 15% risk
When should a child see a doctor for bed-wetting?
When a child reaches the age of 7-8 years, bed-wets and wants to do something about it, it is time to seek help.
Children younger than this generally have neither the desire nor the maturity to work consistently at a bedwetting
program. The child should have a history taken and physical exam done. A urinalysis and culture to screen for
infection should be done. Your child’s pediatrician or family doctor may then wish to consult a pediatric
nephrologist or urologist. If the initial evaluation suggests it, further testing may need to be done to help find the
reason for your child’s problem. This is especially true if your child wets or leaks urine during the day, has had one
or more urinary tract infections, or has other urination problems. In most cases no reason will be found and will
most likely be a maturational delay.
Treatment for enuresis:
Your physician will determine specific treatment for enuresis based on:
•
Your child’s age, overall health and medical history
•
Extent of the condition and expectation for the course of the condition
•
Your child’s tolerance for specific medications, procedures, or therapies
•
Your opinion or preference
NOCTURNAL ENURESIS
The Children’s Medical Center
Nephrology Department
Phone:
937-641-3304
Fax:
937-641-5091
Page
Abiodun Omoloja, M.D.
Pediatric Nephrology
Leonardo M. Canessa, M.D.
Medical Director
One Children’s Plaza, Dayton, Ohio 45404
e-mail: [email protected]
1
NOCTURNAL ENURESIS
How can bed-wetting be overcome?
Many children with bedwetting will improve with time and for reasons that are not understood. It is important to tell
your child that it is a temporary condition. Many children who wet the bed do not feel very good about themselves.
Sometimes parents can place blame on their children who wet the bed, either knowingly or unknowingly. It is
important to be patient with your child. A child does not wet the bed on purpose. The child is not at fault and
should not be punished. The child cannot control the wetting.
Several simple measures may help a child overcome bedwetting. These include:
•
Encouraging intake of the majority of liquids during the early part of the day. Fluids may be restricted 2
hours prior to bedtime.
•
Avoiding dietary bladder irritants such as citrus products (oranges, lemons, pineapples, grapefruits, limes,
tomatoes), carbonation, caffeine and chocolate.
•
Complete, unhurried bladder emptying at bedtime. This is called double voiding. Sit your child on the toilet
to urinate. After they are finished, wait a short amount of time (have them sing the ABCs or a short song)
then try to urinate again. This will help to ensure complete emptying of the bladder.
•
Awaken your child and taking him/her to the bathroom when the parent(s) go to bed (about 2-3 hours after
the child’s bedtime).
•
Making sure the child is not overtired. If a child is overtired, bed-wetting is more likely to occur.
•
Positive reinforcement for dry nights, such as the use of a sticker chart.
•
Bladder training to help increase bladder size and the child’s ability to know when he has to urinate. Once
a day, have your child wait as long as possible to urinate and let the bladder get full. This will increase
bladder capacity and increase your child’s awareness of bladder contractions and the sensation of a full
bladder.
•
Your physician will discuss behavioral modification techniques with you.
For children in whom the above steps have not worked, other treatment may be useful. These may include alarm
devices and medications.
If your child is bothered by bedwetting, professional help may be sought. A child’s self-esteem can be severely
affected by such a seemingly minor problem. Children who are helped to overcome their wetting often have a
much brighter outlook on life. They develop a greater sense of self-confidence and flourish in other aspects of their
lives. Seeking treatment for bed-wetting should not be avoided because of shame or embarrassment.
You can seek more information from our Family Resource Center located on the 2nd floor of the Taggart Pavilion or
from the following web sites:
http://www.nlm.nih.gov/medlineplus
http://www.niddk.nih.gov/
TB 06/05
NOCTURNAL ENURESIS
The Children’s Medical Center
Nephrology Department
Phone:
937-641-3304
Fax:
937-641-5091
Page
Abiodun Omoloja, M.D.
Pediatric Nephrology
Leonardo M. Canessa, M.D.
Medical Director
One Children’s Plaza, Dayton, Ohio 45404
e-mail: [email protected]
2