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Bedwetting

Summary

Enuresis, or bedwetting, is the involuntary passing of urine during sleep in children over the age of five. It is a common condition that often improves with time but can be distressing for both children and parents.

While bedwetting is usually not a sign of a serious medical issue, certain conditions such as diabetes, urinary tract infections, neurological disorders, or emotional stress may contribute to it. A healthcare provider may evaluate these possibilities if bedwetting is persistent or associated with other symptoms.

Diagnosis and When to Seek Help

It is important to seek medical advice if bedwetting:

  • Persists beyond the age of five without improvement
  • Is accompanied by pain, excessive thirst, or unusual daytime urination
  • Begins suddenly after a long period of dryness
  • Occurs alongside other symptoms such as constipation or behavioral changes

A doctor will assess the child’s medical history, perform a physical exam, and may conduct urine tests if needed to rule out underlying conditions.

Management

Most cases of bedwetting improve with time, but several approaches can help:

  • Behavioral strategies:
    • Encouraging regular toilet trips before bed
    • Reducing fluid intake in the evening
    • Using waterproof mattress covers to reduce stress and inconvenience
  • Alarm therapy: Bedwetting alarms can help train the child to wake up when their bladder is full.

Medication: Desmopressin, a medication that reduces urine production at night, may be used in some cases, especially for short-term control (e.g., sleepovers).

Follow-Up and Monitoring

Providing emotional support is key, as bedwetting can affect a child’s confidence. Avoiding blame and using positive reinforcement can help reduce stress and improve outcomes.

With patience, reassurance, and appropriate management, most children outgrow bedwetting successfully.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Increased fluid intake at night
  • Urinary frequency
  • Constipation

Other diagnostic factors

  • Abnormal voiding habits
  • Abnormal breathing pattern at night

Risk factors

  • Genetic predisposition
  • Constipation
  • Upper airway obstruction/sleep-disordered breathing
  • Attention deficit hyperactivity disorder (ADHD)

Diagnostic Investigations

1st investigations to order

  • Urinalysis

Investigations to consider

  • Urinary tract ultrasound

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS