Treat bedwetting properly

Treat bedwetting properly

Every sixth child under five wets at night – around 1.5 per cent of 15-year-olds. “Bedwetting at night is usually a major burden for both the child and the parents,” says Dr. Ingo Franke from the Center for Pediatrics at the University Hospital in Bonn. Fear and shame often affect the self-confidence of children who, for example, do not want to spend the night with friends or refuse to take part in school trips because of nighttime bedwetting, known as enuresis nocturna. But nighttime urination can also occur in adults.  

Bedwetting in children is usually treatable.

If a child does not get dry at night, it is usually not due to a psychological cause such as stress, as is often wrongly assumed but to a delay in maturation. Nocturnal enuresis can usually be successfully treated. First, the child undergoes a comprehensive medical examination to rule out organic causes, such as urinary tract malformations.

With a uroflowmetry device, the doctor can determine whether there is a functional disorder, such as bedwetting at night, or an organic cause, such as an acute urinary tract infection or a neurogenic bladder emptying disorder. Such a device measures urine flow while the bladder is emptied and shows a typical course in certain diseases.


Log drinking behavior

Experience has shown that behavioural therapy achieves good healing successes in nocturnal enuresis. First, the parents keep a log of their child’s drinking behaviour, urination and wetting over four to six weeks.

Up to a quarter of all children become dry after their drinking behaviour has been recorded and subsequently made aware of their drinking habits.

Bell trousers: Rarely useful

The use of bell pants, which make a loud ringing noise as soon as they get wet, is relatively ineffective. This method has a high failure rate of 75 per cent because the children often ignore the ringtone and continue to wet at night.

This method only makes sense if the bell wakes the parents, so they go to the toilet with the child every time it rings. This is the only way this conditioning can bring lasting success. “It is essential how high the suffering of both the affected child and the parents is,” says Franke.


Bedwetting medication?

A drug therapist advises Dr. Ingo Franke: “A child should not regularly take psychotropic drugs because of a delay in maturation.” In addition, the risk of poisoning, if taken incorrectly, is relatively high. However, it makes sense to add specific hormone preparations in exceptional cases, such as upcoming school trips, as they have a short-term effect.

Bedwetting due to respiratory disorders?

In Sydney, scientists have found a link between bedwetting and nocturnal breathing disorders. Children with tonsils or pharyngeal tonsils that are too large could often be freed from bedwetting by removing the obstacle to breathing. Likewise: bedwetting, whose breathing is disturbed because of a too narrow palate, when wearing an expander to stretch the throat, dries up quickly, as the first study results show.

In Germany, research approaches in this area are still needed. The reason why children with nocturnal breathing problems wet themselves is still unclear. “The negative pressure in the chest may decrease so much due to the breathing problems that certain hormones are increasingly produced, which also excrete fluids from the body,” says child nephrologist Franke. “Children with a stubborn course should be examined in a child-friendly sleep laboratory.” 

He considers a study on the connection between breathing disorders and bedwetting beneficial because many children could be helped with simple methods.

Psychological distress from bedwetting

Whether it affects children or adults: This unpleasant malfunction of the body leads to a high level of mental stress and is generally felt to be highly embarrassing. That is why dealing with the topic is rather cramped, and those affected are reluctant to come out. The inability to control one’s body and, as a result, to excrete bodily fluids uncontrollably is a terrifying prospect for anyone, as it takes away some of their autonomy and bodily integrity. 

As a result, adults revert to the state of a helpless toddler, and children feel ashamed because their development has stopped, and they seem unable to grow up.


bedwetting in adults

Although bedwetting is most common in children, it can also affect adults. In addition to the organic causes already mentioned, the cause of urinating at night can also be incontinence. Incontinence, which is derived from the Latin “incontinentia” (non-behaviour) as inability, is due to the disruption of a physical process and can, therefore, affect people of all ages.

A medical examination to determine the exact causes of bedwetting is also advisable for adults to treat it successfully.

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