Enuresis: Definition Causes and Treatment

It is the involuntary emptying of the bladder.

When this occurs during sleep, it is called nocturnal enuresis or wetting the bed at night. The nocturnal enuresis is the disorder most common function of the bladder in children. It can also be daytime.

Causes of Enuresis

The exact cause is unknown. However, most doctors believe that it is due to delayed maturation of bladder function. In a small number of children, the cause of Enuresis is organic, meaning that it refers to a temporary problem associated with a urinary tract infection. In these cases, Enuresis will end after the infection is treated successfully.

In certain situations, Enuresis can be caused by an anatomical problem of the urinary tract. If the urologist suspects this, additional tests may be ordered, including ultrasound or X-rays of the kidneys and bladder.

In many cases, through family history indicates that at least one of the parents also had Enuresis in his childhood. If both parents have had Enuresis when they were children, there is a high probability that their children will be affected.

The control of the bladder is learned little by little, only after the child is old enough to understand that this type of behavior is desirable and is able to respond to stimuli and rewards.

The child must learn to consciously resist the urge to urinate, in other words, to “hold” more time until urination can be done when a toilet is available.

Many options are currently available for the treatment of Enuresis. A well-known behavioral treatment is the bell procedure in which a pad is used that is placed under the child’s buttocks, connected to a noisy bell. If a child begins to urinate in bed, an alarm is triggered that awakens the child. Over time, children learn to identify the feeling of having a full bladder , as doing so helps them predict and avoid alarm.

Finally, children wake up when their bladder is full and are able to use the bathroom properly. The bell and pad procedure eliminates nocturnal enuresis in about 75% of cases, although relapse rates are generally high. However, in most of the time, repeated use of the treatment usually leads to complete healing.

Another well-known type for the treatment of Enuresis consists of a series of strategies that include:

  • Positive reinforcement to urinate properly.
  • Control training in urine retention.
  • Positive practice (parents help their children develop the habit of going to the bathroom at regular intervals during the day, just before sleeping, and at night to avoid accidents).
  • Training in cleaning (children help to clean the bedding and mattress when accidents occur).
  • Mild punishment (mainly disapproval when accidents occur).
  • Encouragement of the family of good habits of cleanliness and successful progress.