Enuresis (Bed Wetting)
Description
An involuntary urination in children over 5 to 6 years old. Enuresis is also called bed-wetting. It may occur at any time of the day but is far more common at night during sleep. With reassurance and training it usually resolves on its own. More rarely bed-wetting may be a sign of other disorders such as: urinary tract infection (bladder infection), diabetes, chronic constipation, and an abnormal bladder or urinary tract. It occurs in about 10% of children over 5. Children who have had urination control initially then develop the disorder may be suffering from life stressors.
Symptoms
Involuntary urination at night.
Tests
A history and physical exam will be performed. A urinalysis (UA) and glucose measurement may be done. If a problem with the urinary tract is suspected other imaging studies such as an ultrasound may be performed.
- UA
- Ultrasound
Treatment
Most children outgrow bed-wetting without specific treatment. Having the child urinate before the bedtime routine and then once again before getting into bed, and avoiding drinking fluids prior to going to bed can be effective. It is important to be reassuring and supportive. Other treatments include: bed-wetting alarms, prescription medications such as DDAVP (desmopressin) and the antidepressant imipramine (Tofranil). If the child is found to have a small bladder oxybutynin (Ditropan) or hyoscyamine (Levsin, Levsinex) may also be prescribed.
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