When bedwetting (nocturnal enuresis) persists, it can be considered a problem. But when do you know whether it’s a medical or psychological condition or simply something you have to wait out?
Bedwetting is a common childhood problem that often goes away on its own as children learn to control their bladders.
According to Cape Town GP Dr Owen Wiese, most children under the age of five wet their bed, but by the age of 10 it’s accepted that at least 95% of children are able to sleep without nocturnal enuresis.
Children gain bladder control at different ages. While some children may be able to stay dry by the age of five, some children take a bit longer. But if the problem persists long after the age of ten, you may want to consider a medical issue as part of an underlying cause.
If your child has remained dry for a prolonged time, but starts wetting the bed out of the blue, there could be an underlying issue.
What medical issues can cause bedwetting?
There are several reasons for bedwetting. These include:
- A urinary tract infection
- Stress or an underlying psychological issue
- Type one diabetes
- A lack of the anti-diuretic hormone that slows down night-time urine production
- A structural problem with the urinary tract or nerve system that can cause incontinence in children. This is, however, rare.
When should my child go to the doctor?
As mentioned, there is no set age when a child fully gains bladder control. We also now know that there are a couple of underlying causes for bedwetting. It is suggested that you take your child to the doctor if:
- Your child complains of a stomach ache or aching during urination and also has a fever. These might be signs of a urinary tract infection.
- Your child hasn’t wet the bed for over three months and the problem starts again.
- There is a risk of stress in your child, such as bullying at school.
- There is blood in the urine.
- Your child also struggles with chronic constipation.
- Your child also has accidents during the daytime.
- Your child also suffers from extreme fatigue and thirst, which could point to diabetes.
How to prepare for the doctor’s visit
Seeing the doctor can be stressful for any child. If you suspect that urination might be caused by a medical problem, here’s how to prepare yourself and your child for the examination.
- Talk to your child ahead of time about the visit. Say that there is absolutely no need to feel embarrassed and that you are not angry at them about the bedwetting.
- Talk to your child beforehand to establish if there could be any psychological causes such as stress.
- Be prepared to give a full history of your child’s bedwetting habits – whether it has stopped and started again, when your child started to sleep through the night without bedwetting etc.
- List any potential other symptoms that your child may have that may point to a medical condition.
- Be prepared to list your child’s full medical history, including medications they are currently taking.
- Give an overview of your child’s toilet habits during the day.
- Know that your child might be referred to a specialist like a urologist or psychologist depending on the doctor’s verdict.
What treatments can be expected?
Treatment for bedwetting will largely depend on the cause. You as a parent should realise that bedwetting is not a surgical condition unless there is a physical, medical cause. Treatment of bedwetting can require medication (in the case of a urinary tract infection) or behaviour modification therapy.