Bedwetting is a taboo subject in childhood

08/04/2014

Although nocturnal wetting is a common childhood urology symptom, it is still a taboo subject. Most children do not learn to control their bladder at night until they are five or six. The time at which a child is finally dry, but can also occur later. For example, every sixth child at the age of five unwittingly goes to bed at night. Especially if the child was already dry, parents are insecure and worried about the reasons of nocturnal urine loss. The fact that behind the bedwetting can cause various causes and in some cases psychological triggers are responsible, know the least.

Nocturnal urine loss is relatively common until the age of five and is considered normal. Only when children are older and about twice a month lose the night control of their bladder, urologists speak of the bedwetting - in technical terms enuresis. If the child has never been dry for more than six months, it suffers from primary enuresis. „Thus, in some children, the development of the nervous system for sphincter control is delayed“, explains Dr. Michael Stephan-Odenthal, urologist and medical director of the medical network Uro-GmbH North Rhine. „Other children sleep so deeply that they do not feel their full bladder. Some children lack the nocturnal increase in a hormone of the pituitary gland, the so-called antidiuretic hormone (ADH). As a result, the body produces more urine just at night than the child's bladder can hold.“ However, when a child starts to wet after being dry for over six months, urologists report secondary enuresis. This often involves changes in the child's life such as the birth of a sibling, the loss of a family member, divorce, relocation and kindergarten or school problems as the cause.

In order to be able to treat enuresis and to exclude physical illness, in addition to the consultation with the pediatrician, a visit to the urologist is always recommended.

Treatment basis forms the so-called urotherapy. „Regular scheduled toilet visits and moderate fluid restriction can already improve bladder control“, describes Dr. Stephan-Odenthal a measure of urotherapy. „A bubble diary maintained by the child strengthens his own responsibility for staying dry. Sometimes these measures alone lead to success.“ If this does not help, a so-called apparative behavioral therapy offers itself. In this case, a doorbell mat or pants triggers an alarm signal as soon as urine gets in the pants. The child is awake and urination is interrupted. „It should learn to pay attention to the signals in his sleep, which informs him of his bladder, and then wakes up by itself“, explains Stephan-Odenthal. A medical treatment is considered to bridge critical situations such as a school trip. Here, the evening ADH hormone supplement with the drug desmopressin reduces the excessive urination at night.