What is night-time enuresis?
Enuresis at night is the involuntary loss of urine during sleep after 5 years. It is popularly known as bedside peeThe number of children in the labour market is about 15%, 7% at the age of 10 and 3% at the age of 12. The incidence is higher in boys than in girls. Under certain circumstances, in a minority of cases, episodes of urine loss may occur in adolescence and adulthood while the person sleeps.
Classification of night-time enuresis
Primary: When the child always had enuresis.
Secondary: When the child was at least 6 months without enuresis and presented again.
Monosymptomatic: The only symptom is enuresis.
Not monosymptomatic: When, besides enuresis, the child presents other mictional symptoms such as urgency, incontinence, etc.
What are the causes of night-time enuresis
Enuresis has multifactorial causes, the main ones being:
- When the parents had enuresis.
- Some children with enuresis have a change in the nocturnal secretion of ADH (Antidiuretic Hormone) and will have increased urine production during the night.
- Some children have involuntary contractions of the bladder during sleep, which cause the loss of urine.
- A child with enuresis has difficulty waking up, not waking up with the signs of a full bladder or with the contraction of the bladder (bladder hyperactivity).
When to look for an expert
Generally most children stop peeing in bed as they grow up. In some cases they may need help controlling enuresis or this is a symptom of other medical conditions requiring attention. So, see your doctor when:
- The child still has episodes of enuresis after the age of seven,
- The child pees in bed again after a few months of control,
- If besides this symptom, she has pain to urinate, abnormal thirst, reddened urine, hard stools or snore.
The diagnosis is basically made through a very detailed medical history, when the doctor obtains the data and details of the child’s symptoms and with the use of an instrument called the Myctional Logbook, in which the child’s myctional pattern during the day and the volume that he urinates during the night are evaluated.
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The treatment of enuresis must be individualized, depending on the type of enuresis it presents. It is important to remember that the involvement and participation of both the child and the family are essential for success.
The advantage of treatment is that it speeds up the healing process, since peeing in bed after the age of 5 can be a hard blow to the child’s self-esteem, and can even negatively interfere with their school performance.
At first it is necessary to make changes in living habits, avoiding liquids before sleeping, as well as avoiding acid foods that can irritate the bladder or those that slow down the functioning of the intestines.
It’s very important for parents to keep in mind that nobody pees in bed because they want to. So criticism and punishment only aggravates the situation. Instead, these children need encouragement, recognition and positive reinforcement when the bedding dries up.
Another therapeutic resource is the use of alarms. They work in the following way: at night, a sensor is placed near the genitals and an audible alarm is attached to the clothing at shoulder height. At the first sign of urine loss, the alarm goes off, the child wakes up and goes to the toilet to pee. Besides the good results it offers, the advantage of this device is that it is free of contraindications and side effects.
Some medications promote good results in controlling night-time enuresis because they help reduce urine production. However, they should only be prescribed by the doctor who accompanies the patient because of the adverse effects they may promote.
- Make the child drink plenty of water during the day so that its brain recognizes the feeling of a full bladder;
- Avoid drinking liquids at night,
- Go to the bathroom before I slept and when I woke up.
- Children who return to bed wetting after being overcome deserve special care, as they may be emotionally insecure because of the birth of a sibling, problems at school, or conflicts in the family.
Source: Urology Portal