Enuresis, a disorder that causes involuntary loss of urine during sleep, affects up to 15% of children over 5 years of age, according to the Brazilian Society of Urology (SBU), and causes restrictions that are sometimes not identified by parents . In addition to a quick diagnosis for the immediate start of treatment, psychological monitoring is very important, both for the child and the family.
“Children who pee in bed complain that they cannot sleep at the home of friends and family, and thus stay out of the famous ‘Pajama Night’, a common activity with colleagues,” says Profa. Dr. Cacilda Andrade de Sá, Faculty of Medicine, UFJF and Coordinator of the Psychology service of the Enuresis Outpatient Clinic of the University Hospital of the Federal University of Juiz de Fora (HU-UFJF). The specialist also adds that the disorder directly impacts school life and social life, in addition to affecting the self-esteem and quality of life of the little ones.
A study carried out in public schools in Juiz de Fora showed that only 4.81% of children with enuresis sought medical help (Netto et al., 2008). In an initial assessment carried out at the Pediatric Urology Outpatient Clinic (HU / UFJF) with children and adolescents suffering from the disorder, doctors found that one of the greatest consequences of enuresis is the punishment suffered because of urinary loss. The child is blamed for what, for him, is already a punishment: “waking up wet”.
Diagnosis and treatment
In addition to considering personal and family history, the diagnosis can be made by observing the child’s evolution regarding psychomotor development and the capacity for filling and emptying the bladder. In addition, it may be necessary to subject the child to clinical tests: genital, neurological, urine and blood.
Most of the time, bedwetting happens due to genetic factors, factors related to the amount of urine produced by the child at night, factors related to bladder function and related to sleep, occurring, therefore, involuntarily, without any guilt on the part of of child.
The occurrence of enuresis that will lead the child to present behavioral and psychological problems. The opposite, that is, bedwetting having a psychological problem as a causal factor occurs in a minority of cases and is usually related to some trauma (stress) suffered by the child and occurs after the child has been dry for a longer period than 6 months. However, in both cases, the child cannot control urination during sleep and the episodes occur without him wanting to.
Psychologist counseling is of great help in treatment. The professional can provide information on toilet training and control, assist in the recovery of children’s self-esteem and also guide parents on how to deal with the disorder.
For parents and caregivers, bedwetting is one of the most frustrating dysfunctions of childhood. As the children grow, so does the expectation that the child will acquire autonomy and responsibility. When not met, this expectation can generate distrust and a feeling of inability, causing guilt and anger.
Family support is essential for successful treatment. “Whoever suffers from enuresis needs to be attended by a specialized professional. Bed wetting is a reality, but it is still being treated as if it were a big family secret ”, comments Cacilda.
According to the psychologist, when parents have to deal with bed wetting, they may experience feelings of anxiety, guilt, loss of confidence in parenting skills and difficulties in the relationship with their children. “Punishment is often used as a way of educating the child, given the impossibility of solving the problem. That is why the inclusion of the whole family in the treatment of the child is fundamental, to eliminate the punishment ”, he concludes.
The website www.semxixinacama.com.br, developed with the support of Laboratórios Ferring, gathers information about Enuresis and aims to guide families on how to deal with bedwetting without trauma, warning about the importance of correct diagnosis and the search for adequate medical treatment. The visitor also has access to a list of the support centers closest to their region, questions and answers on the topic, as well as videos and a blog.