Bedwetting

Alternative Names

Enuresis, Bed-wetting, Nighttime incontinence

What is Bedwetting

Bed-wetting is an involuntary urination at nighttime. Bed-wetting before age 6 or 7 is a normal part of a child's development. There is not a cause for concern. But if bed-wetting continues, it should be treated.

Signs and symptoms

Bed-wetting has the following symptoms:

• A sudden and urgent need to urinate, loss of bladder control (urinary incontinence)
• Urinary incontinence unrelated to an urgent need to urinate
• A frequent need to urinate
• Pain when urinating
• Having to strain to pass urine
• Constipation
• Soiling (accidental loss of bowel control)
• Feeling very thirsty all the time
• High temperature (fever) of 38°C (100.4°F) or above
• Having blood in the urine

Possible complications

Bed-wetting is a frustrating thing. It does not cause any serious health problems. However the guilt and embarrassment can lead to low self-esteem in children. In some cases bed-wetting can cause rashes on the bottom and genital area if the child sleeps in wet underwear.

What causes

Causes of bedwetting are not known for sure. The possible causes of enuresis are:

• A small bladder
• Inability to recognize a full bladder
• A hormone imbalance
• Stress
• Urinary tract infection
• Sleep apnea
• Diabetes
• Chronic constipation
• A structural problem in the urinary tract or nervous system

Prevention

You can reduce the number of bed-wetting accidents following some useful tips:

• Support your child emotionally
• Reduce your child evening fluid intake
• Have your child go to the bathroom before getting into bed
• Set a goal for your child of getting up at night to use the toilet
• Make sure the child has easy access to the toilet
• Reward your child for remaining dry
• Consider using diapers or pull-ups at night

Treatment

Most children outgrow bed-wetting on their own gradually. If your child is terrified about wetting the bed while asleep, some treatments may be recommended:

• Moisture alarms connected to a moisture-sensitive pad on your child's pajamas or bedding. The moisture alarm sounds when your child begins to urinate.
• Medications to slow nighttime urine production (e.g. desmopressin acetate), calm the bladder (oxybutynin (Ditropan) or hyoscyamine (Levsin)), change a child's sleeping and waking pattern (e.g. antidepressant imipramine (Tofranil)).