Bedwetting or enuresis is active urination, comprehensive, unconscious, involuntary, occurring during sleep. Enuresis can only speak from 5 years because it is the age or the physiological control of the bladder sphincter is acquired.
Primary enuresis is when the child has never been clean. It occurs in 10% to 15% of five year olds and 6% to 8% of those eight years. In adolescents, there is still about 1% to 2% of cases.
By cons, bedwetting is secondary if it succeeds complete cleanliness period of at least 6 months. In secondary enuresis, it is useful to practice investigated for a urinary tract infection or intestinal parasites.
Isolated nocturnal enuresis accounts for 65% of cases, but there are isolated diurnal enuresis (3%) and nocturnality and diurnal enuresis.
We distinguish :
The total enuresis: the child urine every night.
Enuresis sparse after 8 years where we find a correlation between wet nights and events of the previous day.
Intermittent enuresis: accidents only occur during certain periods.
Episodic enuresis: accidents happen exceptionally in diseases, dividers, important family events etc.
We do not talk of enuresis when it comes to polyuria (urine abundant in the case of various diseases: diabetes, kidney disease, etc.), abnormal urination (urinary incontinence) with chronic urinary retention or abnormal location ureters, loss of urine during an epileptic seizure … etc. It does not concern the delay acquisition of bowel control in people deficient in motor or mental level.
Psychologists and psychiatrists length about this problem but the only causes are not always psychological. Indeed, the psychological factor is involved mainly in the case of secondary enuresis. And in practice, most children who wet the bed are seen by the pediatrician children quite normal. Families are families all what’s more normal. They can of course be minor glitches, but that does not?
First cause of heredity. Family factors are possible because in 70% of cases, bedwetting is family. A child whose parent has enuretic almost a one in two chance of being and the risk reached more than 75% when both parents had this problem.
In the case of primary enuresis is the immaturity of the bladder which is often responsible. There is talk of bladder immaturity which is a delay of neuromuscular reflexes that control the bladder. It can also be a hormonal disorder or ADH Antidiuretic hormone that is responsible for the production of urine.
Then the causes are varied and often psychological. These are often major changes in his life that are responsible. They usually cause secondary enuresis.
Enuresis always heal eventually but enuresis is ancient, more treatment is difficult. Current treatment is based on drugs and especially medical care and / or the child’s psychological.
Another treatments options
Drug treatment of nocturnal enuresis is not systematic. According to the latest recommendations of health authorities, the assumption is primarily based on educational and hygienic measures. In case of failure, drug or behavioral treatment (alarm system) can be done, but not before the age of 6 years. For medication desmopressin in tablet form is approved for the treatment of enuresis and some antidepressants.
The doctor will give the child a simple anatomical and physiological information adapted to demystify the symptom and make him understand that he can heal. A fun book self-monitoring may be delivered to him that he could enter the dry, or wet nights every morning during 3 months of treatment.
Psychological care of child
In talking with the child, the doctor will know if he is indifferent to his symptom, or rather uncomfortable if he tries to cover the wet cloth …
The pediatrician must, first, convince parents not to intervene. They have to play the indifference not make comment about this symptom, do not make fun of him ( “you pee in bed like a baby,” “You are a pig!” Etc.), do not punish or reward him if he became clean etc … do not expose the wet sheets neighbors to “shame him” or force him to wash himself his wet underpants, nor of course the deal in infants. In a word, it is imperative to let the child alone!
The “pee stop” is an electrical device that triggers an alarm upon issuance of the first drops of urine. In concrete layer is placed in the child’s pants (or a mattress laid on the mattress) and connected to the device. When the sleeping child begins urination, the probe detects the humidity and the buzzer sounds. The child fully awake, can then be going to the bathroom to finish urinating.