Bedwetting (Enuresis)

Start of School Can Worsen Bedwetting in Children

Bedwetting (Enuresis) | Johns Hopkins Medicine

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Bedwetting perennially drives parents to the pediatric urology clinic at Johns Hopkins Children’s Center, but September — and the start of the school year — always brings a predictable uptick in visits, according to pediatric urologist Ming-Hsien Wang, M.D.

“Back to school is a physically and emotionally stressful time for many children, compounded by the sudden change in sleep patterns and schedules that generally wreak havoc on eating and other routines established over the summer,” Wang says.

Children who experience back-to-school flare-ups should stick to a regular “pee” schedule through the day, says Wang, who s to send parents home with a note to their child’s teacher verifying the child’s urologic condition and recommending bathroom visits every two or so hours. The brain controls the bladder, Wang explains, so establishing a clockwork potty routine during the day helps improve brain-bladder communication in general.

Bladder control develops gradually in children, with nighttime bladder control, the final stage of the process, reached generally by age 6 or 7. A small number of children continue to wet their beds until age 10 and beyond.

Physical and emotional stressors are well-known contributors to both night-time enuresis and daytime incontinence in children, says Wang, and the vast majority of cases are due not to anatomical or biological problems, but to lifestyle issues such as lack of regular potty times, good hydration and appropriate diets.

“Changes in lifestyle take care of 80 percent of these problems,” says Wang, who only rarely prescribes drugs, which can have side effects, or bedwetting alarms, which disrupt the sleep cycles of both the child and the family.

She advises:

  • Ruling out medical conditions that cause incontinence, including diabetes, urinary tract infections and kidney disease, as well as certain anatomic abnormalities of the genitourinary tract and some neurological disorders that affect brain-bladder signaling
  • Letting your child know that this is a fixable condition and providing lots of emotional support
  • Eating a diet rich in fiber with plenty of raw fruits and vegetables every day
  • Drinking plenty of water to ease urination: The marker of good hydration is urine color, which should be pale yellow or as clear as water
  • Send your child to school with a bottle of water (flavored, if necessary, with a bit of honey or lemon juice) rather than sugar-rich drinks
  • Stopping fluids about three hours before bedtime
  • Emptying the bladder immediately before going to bed
  • Keeping a toileting diary for several days before the visit to the doctor and writing down how often a child empties the bladder, along with the number of daytime and nighttime accidents
  • Although bedwetting can increase around back-to-school time, Wang says, the condition appears to be on the rise year-round.

“Anecdotally, we are seeing more and more patients referred to us by general pediatricians,” says Wang.

While experts have yet to verify the increase scientifically or tease out the factors behind it, Wang believes that more awareness of the condition, combined with lifestyle choices are the two main drivers.

Poor nutrition and eating and voiding habits are major contributors, Wang says, and children with constipation are also prone to bedwetting because both interfere with control of the pelvic muscles involved in toileting.

“When children cannot move their bowels, they also tend to hold their urine, which in turn makes them more ly to have accidents.”

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/start-of-school-can-worsen-bedwetting-in-children

Bedwetting: 5 Facts to know and 5 Tips to keep your sanity

Bedwetting (Enuresis) | Johns Hopkins Medicine

“Mama, I have to go peepee,” the small voice calls from a dark room across the hall. I can feel the anxiety rise up from my stomach as I stumble from my own bed.

Fingers crossed in my mind, I hope to find a dry child, and a dry bed, and that we make it to the bathroom.

Most of the time we do, but then there are the nights when I find myself in front of the washing machine with a pile of sheets at 3am… You are not alone.

FACTS:

1)      Bed-wetting is common.  Also known as nocturnal enuresis, bedwetting is actually considered normal for kids until the age of five. After age five, 15% of children will still experience bedwetting. At the age of 10, 5% of children still wet the bed. Boys are twice as ly as girls to struggle with this.

2)      Normal bed-wetting occurs without any other symptoms. That means no pain, fevers, weight loss, loss of daytime control, frequent urination, weak or inconsistent streams of urine, increased hunger or thirst, or other problems.

3)      It is hard to stay dry at night. The bladder has its own complex system of nerves and also relies on detailed communication with the brain. These systems take a long time to develop and train.

The systems are also affected by genetics (bed wetting runs in families), hormone release patterns, sleep patterns, abnormal muscle activity of the bladder and other varied factors that you and your child cannot control.

4)      Even children who potty train easily during the day may struggle for months or years with bedwetting.

5)      Sometimes, a stressful life event will result in the start or return of bedwetting.  This is known as secondary nocturnal enuresis. This is less common then the primary form that begins during toilet training.

TIPS:

1)      CALL your pediatrician for a medical evaluation if your child has any other symptoms that you notice in association with their bed wetting (mentioned above: pain, fevers, weight loss, loss of daytime control, frequent urination, weak or inconsistent streams of urine, increased hunger or thirst, or other problems).

2)      RELAX as much as possible. Most children will outgrow this in time.  It is not your child’s fault and it is not your fault. Stressing yourself out or reprimanding your child only leads to further emotional distress and embarrassment for you both. It will not help the problem.

3)      PURCHASE plastic mattress covers/protectors and some inexpensive bedding that is easy to wash and can be changed out quickly.  You can even layer sheets and protectors so that the bed is already “made” as soon as the wet layer is removed.

4)      MAXIMIZE your child’s chance of success at night by

  1. Avoiding sugary or caffeine containing drinks at night
  2. Encourage drinking of fluids in the morning and afternoon and discourage lots of drinking right before bed. This can be hard for children who attend school.
  3. Have your child urinate as the very last thing they do before bed
  4. Consider keeping a potty chair right by the bed and consider use of nightlights, etc. to make nighttime toilet usage as easy as possible. Remind and encourage them that getting bed to use the toilet is the right choice and praise them for it.
  5. Maintaining a consistent nap and sleep schedule may help. Children who are sleep-deprived or “over tired” are more ly to wet the bed.
  6. Avoid routine use of pull-ups/diapers/training pants, especially in older children who have a personal interest in ending their bed wetting.

5)      DISCUSS training techniques and other treatment options with your pediatrician especially if your child is older than seven. Younger children often respond well to motivational therapy (sticker charts, predetermined awards).

Older children may make use of moisture alarms, scheduled nighttime urination, and other mental training techniques.

A medication is available with a prescription from your doctor, but this only works for certain types of bedwetting and is most suited for special nights sleep overs/camps etc.

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Source: https://childrensmd.org/browse-by-age-group/toddler-pre-school/bedwetting-5-facts-to-know-and-5-tips-to-keep-your-sanity/

Enuresis Treatment & Management: Approach Considerations, Initial Management, Alarm Therapy

Bedwetting (Enuresis) | Johns Hopkins Medicine

Desmopressin acetate is the preferred medication for treating children with enuresis. A Cochrane review of 47 randomized trials concluded that desmopressin therapy reduces bedwetting; children treated with desmopressin had an average of 1.3 fewer wet nights per week. [17]

The tablet and the orally disintegrating tablet (melt) have similar efficacy. The orally disintegrating tablet is not available in the USA. The intranasal formulation carries a black box warning from the US Food and Drug Administration (FDA) and is no longer recommended for enuresis, because of the risk for severe hyponatremia that can cause seizures and death.

Desmopressin acetate tablets or orally disintegrating tablets should be administered 1 hour before bedtime. The recommended starting dose for the tablet is 0.2 mg, and the drug can be titrated as necessary to a maximum dose of 0.6 mg. The equivalent starting dose for the orally disintegrating tablet is 120 µg, and the maximum dose is 360 µg.

Desmopressin’s immediate onset of action allows the flexibility of choosing either intermittent administration for special occasions or long-term use to maintain dryness. For long-term use, desmopressin can be prescribed in 3-month quantities and discontinued between prescriptions to determine whether the wetting persists and thus whether continued use is justified.

The safety profile of desmopressin acetate is favorable, and many studies have documented low rates of adverse effects. For the tablet, the incidence of minor adverse events is not significantly different from that for a placebo.

The only serious adverse effect reported in patients with enuresis treated with desmopressin is the development of seizure or other central nervous system (CNS) symptoms due to water intoxication. A review of case reports of water intoxication associated with desmopressin confirmed that excess fluid intake was a feature in at least six of 11 individuals. [21]

This serious adverse effect can be prevented by educating the patient not to consume an excess of fluids on any evening in which desmopressin is administered.

A maximum of 1 cup of fluid should be offered at the evening meal, no more than 1 cup between mealtime and bedtime, and no fluid at all within the 2 hours preceding bedtime. Early symptoms of water intoxication include headache, nausea, and vomiting.

If these symptoms develop, the medication should be discontinued and the child promptly assessed by a physician.

An FDA alert from December 2007 cited 61 postmarketing cases of hyponatremic-related seizures associated with the use of desmopressin. In 55 cases, sodium levels of 104-130 mEq/L during the seizure event were reported. In two cases, the patients died (both patients experienced hyponatremia and seizures).

There were 36 cases associated with intranasal formulations, 25 of which occurred in pediatric patients younger than 17 years. The most commonly reported indication for use in these 25 pediatric cases was enuresis. In 39 of the 61 cases, there was at least one concomitant drug or disease that was also associated with hyponatremia, seizures, or both.

Combination of alarm therapy with desmopressin therapy has been reported to result in dryness not achievable with either therapy alone.

An anticholinergic medication might be helpful in some patients, especially those with overactive bladder, dysfunctional voiding, or neurogenic bladder. These medications reduce uninhibited detrusor contractions, increase the threshold volume at which an uninhibited detrusor contraction occurs, and enlarge the functional bladder capacity.

Oxybutynin chloride and tolterodine are commonly prescribed in this setting. Oxybutynin chloride also has antispasmodic and analgesic properties. Anticholinergic adverse effects include dry mouth, blurred vision, facial flushing, constipation, poor bladder emptying, and mood changes. Constipation as an adverse event is especially problematic in that it might increase the risk for wetting.

Anticholinergic medications should not be administered during a fever, because an anticholinergic effect is a decrease in sweating. Similarly, they should be used with caution in children who exercise or play strenuously, especially on hot days.

Oxybutynin is given in a dose of 2.5-5 mg administered at bedtime. A long-acting preparation is available but has not been approved for use in children.

Tolterodine is not approved for use in children younger than 12 years.

Flavoxate, a urinary spasmolytic, might be helpful in some patients with overactive bladder and dysfunctional voiding but is approved only for children older than 12 years.

The combination of desmopressin acetate and oxybutynin chloride might be efficacious in children with overactive bladder or dysfunctional voiding who respond to anticholinergic therapy with improved daytime symptoms but who continue to wet at night. Long-acting preparations of oxybutynin may be more efficacious for combined use with desmopressin.  

A Cochrane review of 64 randomized trials concluded that imipramine is effective in reducing bedwetting; children treated with imipramine had one fewer wet night per week. [18] The relapse rate is high when the medication is discontinued. The usual dose, taken 1-2 hours before bedtime, is 25 mg for patients aged 6-8 years and 50-75 mg for older children and adolescents.

Adverse effects include constipation, difficulty initiating voiding, irritability, drowsiness, reduced appetite, and personality changes.

Imipramine overdose can be fatal, and a cautionary warning is necessary with every prescription.

Because of the unfavorable adverse effect profile and the significant risk of death with overdose, the World Health Organization (WHO) does not recommend imipramine for the treatment of enuresis.

Source: https://emedicine.medscape.com/article/1014762-treatment

Start of school can worsen bedwetting in children

Bedwetting (Enuresis) | Johns Hopkins Medicine

Bedwetting perennially drives parents to the pediatric urology clinic at Johns Hopkins Children's Center, but September — and the start of the school year — always brings a predictable uptick in visits, according to pediatric urologist Ming-Hsien Wang, M.D.

“Back to school is a physically and emotionally stressful time for many children, compounded by the sudden change in sleep patterns and schedules that generally wreak havoc on eating and other routines established over the summer,” Wang says.

Children who experience back-to-school flare-ups should stick to a regular “pee” schedule through the day, says Wang, who s to send parents home with a note to their child's teacher verifying the child's urologic condition and recommending bathroom visits every two or so hours. The brain controls the bladder, Wang explains, so establishing a clockwork potty routine during the day helps improve brain-bladder communication in general.

Bladder control develops gradually in children, with nighttime bladder control, the final stage of the process, reached generally by age 6 or 7. A small number of children continue to wet their beds until age 10 and beyond.

Physical and emotional stressors are well-known contributors to both night-time enuresis and daytime incontinence in children, says Wang, and the vast majority of cases are due not to anatomical or biological problems, but to lifestyle issues such as lack of regular potty times, good hydration and appropriate diets.

“Changes in lifestyle take care of 80 percent of these problems,” says Wang, who only rarely prescribes drugs, which can have side effects, or bedwetting alarms, which disrupt the sleep cycles of both the child and the family.

She advises: • Ruling out medical conditions that cause incontinence, including diabetes, urinary tract infections and kidney disease, as well as certain anatomic abnormalities of the genitourinary tract and some neurological disorders that affect brain-bladder signaling • Letting your child know that this is a fixable condition and providing lots of emotional support • Eating a diet rich in fiber with plenty of raw fruits and vegetables every day • Drinking plenty of water to ease urination: The marker of good hydration is urine color, which should be pale yellow or as clear as water • Send your child to school with a bottle of water (flavored, if necessary, with a bit of honey or lemon juice) rather than sugar-rich drinks • Stopping fluids about three hours before bedtime • Emptying the bladder immediately before going to bed • Keeping a toileting diary for several days before the visit to the doctor and writing down how often a child empties the bladder, along with the number of daytime and nighttime accidents

Although bedwetting can increase around back-to-school time, Wang says, the condition appears to be on the rise year-round.

“Anecdotally, we are seeing more and more patients referred to us by general pediatricians,” says Wang.

While experts have yet to verify the increase scientifically or tease out the factors behind it, Wang believes that more awareness of the condition, combined with lifestyle choices are the two main drivers.

Poor nutrition and eating and voiding habits are major contributors, Wang says, and children with constipation are also prone to bedwetting because both interfere with control of the pelvic muscles involved in toileting.

Story Source:

Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.

Source: https://www.sciencedaily.com/releases/2010/09/100925120432.htm

Enuresis Clinical Presentation: History, Physical Examination

Bedwetting (Enuresis) | Johns Hopkins Medicine

The best time to investigate and discuss enuresis is when the parent or patient first raises the issue in the physician’s office. However, the best time to treat the behavior might depend more on the motivation of the child.

The most important aspect of the investigation is a meticulous history, which can establish the diagnosis, lead to more precise treatment recommendations, and minimize the need for invasive and costly investigations. The history should include the following:

  • Hydration history
  • Daytime voiding pattern
  • Toilet training history
  • Number and timing of episodes of bedwetting
  • Sleep history
  • Family history of nocturnal enuresis
  • Nutrition history
  • Behavior, personality, and emotional status

If the history is not clear, request that the family record fluid intake, daytime voiding, and episodes of bedwetting for at least a 2-week period.

A sleep history should include the times the child goes to bed, falls asleep, and awakens in the morning. Parents should be asked to make a subjective assessment of the child’s depth of sleep.

The presence of restless sleep, snoring, and the type and frequency of nocturnal arousals (eg, nightmares, sleep terrors, or sleepwalking) should be determined.

Whether the child has experienced periods of dryness and the circumstances of these episodes should also be determined.

A nutrition history should include the timing, quantity, and type of fluid and solid food intake during the entire day, not merely after supper.

Many children with enuresis do not drink appreciable amounts of liquids during the school day, arrive home from school thirsty, and drink most of their daily fluids in the 4 or 5 hours before bedtime, a pattern that favors nocturnal production of urine.

An assessment of the emotional impact on the child is important. Information should be solicited from both the parents and the child. Basic and revealing information includes whether the child has experienced teasing by family or friends or has self-restricted participation in school, sleepovers, or trips.

Alertness to symptoms reflecting common underlying problems is important. Patients with overactive bladder or dysfunctional voiding usually present with frequency, urgency, squatting behavior, and daytime and nighttime wetting. Cystitis and constipation are common associated problems in patients with overactive bladder or dysfunctional voiding.

Symptoms of cystitis include dysuria; cloudy, foul-smelling urine; visible blood in the urine; frequency; urgency; and daytime and nighttime wetting. Symptoms of cystitis can be very subtle in some children.

Constipation manifests as infrequent and painful passage of hard wide stool, encopresis, and colicky periumbilical pain. Some children with enuresis have bowel patterns that influence bladder control and capacity, but they are not constipated by conventional definitions.

Thus, the history should include a careful assessment of the frequency and timing of bowel movements, whether the stool is easy to pass, and whether the child needs to push. Children who defecate later in the day, who miss days, and who need to push should be identified.

Bowel-related problems and gait abnormalities are often present in patients with neurogenic bladder.

Symptoms of sleep-disordered breathing (SDB) include snoring, mouth breathing, lack of restful sleep, and tiredness the following morning.

The hallmark symptoms of urethral obstruction are the need to wait or push to initiate voiding and a weak or interrupted stream.

When bedwetting is a feature of a major motor seizure, parents may hear nocturnal sounds associated with abnormal muscle movements.

Girls with ectopic ureter are “always” wet.

Symptoms of diabetes mellitus include polyuria, polydipsia, and weight loss despite a voracious appetite. Patients with diabetes insipidus present with polyuria, polydipsia, and symptoms related to the underlying hypothalamic or renal causes.

Source: https://emedicine.medscape.com/article/1014762-clinical

Bedwetting (Enuresis)

Bedwetting (Enuresis) | Johns Hopkins Medicine

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Urinary incontinence (enuresis) is the medical term for bedwetting.Incontinence is accidental or intentional urination in children who are atan age where they should be able to have control of their bladders.

Girlsusually obtain bladder control before boys do. Incontinence may bediagnosed in girls older than age 5 and in boys who are older than age 6who are still having urinary control problems.

There are different types oedwetting that may occur, including the following:

  • Diurnal enuresis (wetting during the day)
  • Nocturnal enuresis (wetting during the night)
  • Primary enuresis (occurs when the child has never fully mastered toilet training)
  • Secondary enuresis (occurs when the child did have a period of dryness, but then returned to having periods of incontinence)

What are some key facts about urinary incontinence (enuresis)?

  • According to the American Academy of Pediatrics (AAP), nocturnal enuresis affects 5 million children older than age 6 in the U.S.
  • Nocturnal enuresis occurs more frequently in boys than in girls.
  • Of the children with bedwetting, most have wetting at night.
  • Primary enuresis is the most common form of urinary incontinence among children.

What causes urinary incontinence?

There are many factors that may be involved, and many theories that aregiven for why children wet. The following is a list of some of the possiblereasons for the problem:

  • Poor toilet training
  • Delay of the ability to hold urine (this may be a factor up to about age 5)
  • Small bladders
  • Poor sleep habits or the presence of a sleep disorder
  • A problem with the proper functioning of hormones that help to regulate urination
  • Most children who wet the bed have at least one parent or a close relative who also suffered from bedwetting as a child
  • Medication that affects sleep

How is urinary incontinence (enuresis) diagnosed?

Urinary incontinence (enuresis) is usually diagnosed a completemedical history and physical examination of your child. In addition totalking with you and the child, your child's doctor may perform thefollowing to help rule out other causes for the wetting:

  • Urine tests (to make sure there is not an underlying infection, or condition such as diabetes)
  • Blood pressure measurement
  • Blood tests

What is the treatment for urinary incontinence (enuresis)?

Specific treatment for enuresis will be determined by your child's doctor:

  • Your child's age, overall health, and medical history
  • Extent of the condition
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Prior to starting treatment, it is important to know that:

  • The child is not at fault and should not be punished. The child cannot control the wetting.
  • According to the AAP, enuresis usually goes away on its own in about 15 percent of affected children each year.

Treatment may include:

  • Positive reinforcement of the child (for example, the use of sticker charts for dry nights)
  • Use of night-time alarms to help tell the child when wetting is occurring
  • Medications, as prescribed by your child's doctor (to help control the wetting)
  • Bladder training to help increase the bladder size and the child's ability to know when he or she has to urinate. (This is done by having the child wait as long as possible during the day to urinate and let the bladder get full.)
  • Decrease fluids (AAP suggests this approach if the child believes it helps) and avoid caffeine at night

In addition, counseling of the child and family may help to determine anystress the child may be under.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/bedwetting-enuresis

Bedwetting (Nocturnal Enuresis)

Bedwetting (Enuresis) | Johns Hopkins Medicine

The medical name for not being able to control your pee is enuresis (pronounced: en-yuh-REE-sis). Sometimes enuresis is also called involuntary urination.

Nocturnal enuresis is involuntary urination that happens at night while sleeping, after the age when a person should be able to control his or her bladder.

(Involuntary urination that happens during the day is known as diurnal enuresis.)

Most of us think of bedwetting as something that happens with little kids. But this problem affects about 1–2 every 100 teens.

What Happens in Enuresis?

There are two kinds of enuresis:

  • Someone with primary nocturnal enuresis has wet the bed since he or she was a baby. This is the most common type of enuresis.
  • Secondary enuresis is a condition that develops at least 6 months — or even several years — after a person has learned to control their bladder.

The bladder is a muscular receptacle, or holding container, for pee (urine). It expands (gets bigger) as pee enters and then contracts (gets smaller) to push the pee out.

In a person with normal bladder control:

  • Nerves in the bladder wall send a message to the brain when the bladder is full.
  • The brain then sends a message back to the bladder to keep it from automatically emptying until the person is ready to go to the bathroom.

But people with nocturnal enuresis have a problem that causes them to pee involuntarily at night.

What Causes Enuresis?

Doctors don't always know the exact cause of nocturnal enuresis. But they think that these things may play a role:

  • Hormonal problems. A hormone called antidiuretic hormone, or ADH, causes the body to make less pee at night. But some people's bodies don't make enough ADH, which means their bodies may make too much urine while they're sleeping.
  • Bladder problems. In some people with enuresis, too many muscle spasms can prevent the bladder from holding a normal amount of pee. Some teens and adults also have relatively small bladders that can't hold a lot of urine.
  • Genetics. Teens with enuresis often have a parent who had the same problem at about the same age. Scientists have identified specific genes that cause enuresis.
  • Sleep problems. Some teens may sleep so deeply that they don't wake up when they need to pee.
  • Caffeine. Using caffeine causes a person to pee more.
  • Medical conditions. Medical conditions that can trigger secondary enuresis include diabetes, urinary tract abnormalities (problems with the structure of a person's urinary tract), constipation, and urinary tract infections (UTIs).
  • Psychological problems. Some experts believe that stress can be linked to enuresis.

Doctors don't know exactly why, but more than twice as many guys as girls have enuresis. It is often seen in combination with ADHD.

How Is Enuresis Diagnosed?

If you're having trouble controlling your urine at night, talk to your doctor to learn more about nocturnal enuresis and to rule out the possibility of a medical problem.

The doctor will do an exam, and ask you about any concerns and symptoms you have, your past health, your family's health, any medicines you're taking, any allergies you may have, and other issues.

This is called the medical history. He or she may ask about sleep patterns, bowel habits, and urinary symptoms (such as an urge to pee a lot or pain or burning when you pee).

Your doctor may also discuss any stressful situations that could be contributing to the problem.

The initial exam will probably include a urinalysis and urine culture. In these tests, urine is examined for signs of disease. Most of the time in people with nocturnal enuresis, these test results come back completely normal.

How Is Enuresis Treated?

Doctors can do several things to treat bedwetting, depending on what's causing it. If an illness is responsible, which is not very common, it will be treated.

If the history and physical exam do not find a medical problem and the urine tests are negative, several behavioral approaches can be used for treatment:

  • Manage what you eat and drink before bed. People with nocturnal enuresis can take some basic steps to prevent an overly full bladder, such as decreasing the amount of fluids they drink before going to bed. You can reduce the chances that you'll wet the bed by going to the toilet just before bedtime.

    It may help to avoid eating foods that can irritate the bladder. These include coffee, tea, chocolate, and sodas or other carbonated beverages with caffeine.

  • Imagine yourself dry. Using a technique called positive imagery, where you think about waking up dry before you go to sleep, can help some people stop bedwetting. Some people find that rewarding themselves for waking up dry also works.
  • Use bedwetting alarms. Doctors and nurses sometimes prescribe bedwetting alarms to treat teens with enuresis. With these alarms, a bell or buzzer goes off when a person begins to wet the bed. Then, you can quickly turn the alarm off, go to the toilet, and go back to sleep without wetting the bed too much. It can take many weeks for the body to unlearn something it's been doing for years. Eventually, you can train yourself to get up before the alarm goes off or to hold your urine until morning.

    People who sleep very deeply may need to rely on a parent or other family member to wake them up if they don't hear the alarm. The key to bedwetting alarms is waking up quickly — the sooner a person wakes up, the more effective the behavior modification for telling the brain to wake up or send the bladder signals to hold the pee until the morning.

  • Sometimes doctors treat enuresis with medicine. But no medicine has been proved to cure bedwetting permanently, and the problem usually returns when the medicine is stopped. Doctors sometimes prescribe a manmade form of ADH to decrease urine buildup during the night. Other medicines relax the bladder, allowing it to hold more pee.

If you're worried about enuresis, the best thing to do is talk to your doctor for ideas on how to cope with it. Your mom or dad can also give you tips on how to cope, especially if he or she had the problem as a teen.

The good news is that it's ly that bedwetting will go away on its own.

Reviewed by: Marcella A. Escoto, DO

Date reviewed: December 2018

Source: https://kidshealth.org/en/teens/enuresis.html