During childhood (up to 5 years of age), urinary incontinence is a common and normal ailment, both day and night. However, when it persists in the following years (i.e. when it becomes chronic) and if it occurs during sleep, bedwetting can be a source of discomfort for any patient, be it a child or an adult. Below we will talk to you in more detail about bedwetting and all its consequences.
What is it about?
Enuresis is the medical term attributed to the involuntary passing of urine. It can occur during the day, and in this case we are talking about daytime enuresis, or, more often, at night, and we are talking about nocturnal enuresis.
This disorder is very common in children: it affects up to 12% of children up to 6 years and up to 7% of children up to 10 years. It has a higher incidence in males and usually disappears with adolescence. However, in a small percentage of cases the problem persists and affects young people over the age of 20, causing them various social and psychological problems.
Uncontrolled urination is a normal phenomenon that occurs at specific stages of a child’s development. Most children are unable to control their bladder and urethral sphincter before 3 years of age. In this phase, enuresis is not considered a disease, since it is a normal physiological condition, due to the immaturity of the urinary tract.
From this age on, however, children gradually learn to control their bladder, learning to know when it is full and controlling the act of urination. Night control is more difficult and slower to achieve, so bed-wetting is common in children up to 6 years of age.
Minimum frequency needed for diagnosis
There is currently no unanimity on the criteria for diagnosing this disorder based on the frequency of episodes. Following this, to diagnose bedwetting, the criteria range from two nights a week when the little one wets the bed, to one night a week or even 4 nights a month. In any case, to obtain a correct diagnosis and follow the appropriate treatment it is necessary to make an individual assessment, which will vary from case to case.
Thus the treatment and the frequency criteria of the episodes will not be the same for children under 5 years – in whom the phenomenon is considered normal – and for adolescents, in which a single episode can be a symptom of a problem.
Causes of bedwetting
Almost always the disturbance is due solely to the fact that the child, while sleeping, does not have sufficient control over his bladder to understand that it is full; he is unaware of it and pees himself involuntarily.
In a small percentage of cases, the phenomenon is associated with the presence of another disease, such as diabetes or disorders related to the urinary tract. In these cases, enuresis also occurs during the day (diurnal enuresis) and the therapy will be very different.
Treatment of nocturnal enuresis
In many cases the situation does not require therapy. When it occurs in children under the age of 5, it is considered a normal and temporary problem, which diminishes with growth.
However, there are some guidelines that can help the child and reduce the number of episodes. These guidelines are actually part of a behavioral treatment that consists of explaining the reason for the problem to parents and children, in order to limit the extent of the disorder. Some of the possible tips to follow are:
- Explain to the child that he has no reason to be ashamed of the situation. Let him know that it is a normal condition due to the delayed maturation of the urinary system.
- Do not argue or embarrass the child.
- Do not wake the baby during the night to prevent bedwetting or reduce his fluid intake.
- It is advisable to set a time to pee: it will help the child to maintain control over urination.
- Explain to the child that they need to drink more fluids during the day, but reduce them as evening approaches.
- The use of diapers is contraindicated, as it confuses the baby and prevents him from learning to control urination.
Pharmacological treatment is recommended only in the most severe cases. In these cases the drugs administered will be designed to limit the urge to urinate (antidiuretic drugs) or to control sleep.
Finally, although bedwetting is common in younger children, it is important not to neglect it. Behavioral therapies and constant family support are essential to overcome the problem. finally, it is important to bring each case to the attention of a professional to make sure it does not hide other problems.