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Research Review

Nighttime Bedwetting Treatable with Simple Steps, Patience

Nighttime bedwetting, or primary nocturnal enuresis, is a common condition in children, and most outgrow it. However, if bedwetting occurs after age 6 or 7, it may raise social and psychological issues.

About 15% of five-year-olds and about 5% of 10-year-olds wet the bed involuntarily unrelated to an underlying medical condition. The condition happens more often in boys than in girls and tends to run in families. Nighttime bedwetting becomes a real problem when it starts affecting children’s socialization.

Bedwetting is not due to a behavioral or mental problem or laziness of the child, says Paul Austin, MD, an associate professor of surgery at Washington University in St. Louis and a pediatric urologist at St. Louis Children’s Hospital. Rather, some of the most common causes of bedwetting include: genetic factors; kidney problems that involve a lack of anti-diuretic hormone or vasopressin, which is produced normally at night to limit the formation of urine during sleep; problems with the brain wherein a full bladder fails to wake up the child; problems with the bladder wherein the bladder is too small for his or her age.

All of these common causes are temporary and resolve as the child matures. Parents should exercise patience with their child and understand that their child is not wetting the bed on purpose.

About 15% of children who wet the bed grow out of it each year, but if it pursues, there are several ways to treat the condition. Treatment is recommended when bedwetting impacts the child’s self-esteem or socialization. Because of the different causes for bedwetting, treatment is tailored for each child. This can include behavior modification techniques for when the brain is not waking the body, a synthetic antidiuretic hormone medication called desmopressin for when too much urine is produced; and another medication can be used when the bladder appears to be small, to help the bladder relax and hold more urine.

“Children who take medication for the condition can take a break from the medication after six months,” Austin says. “Within a week or two, families can quickly determine whether the child has outgrown the problem. If not, medication is prescribed for another six-month cycle. Over time, the bedwetting will eventually stop.”

— Source: Washington University in St. Louis