Enuresis is physiological voiding that occurs at an unwanted place and time. It is a symptom rather than a disease. During their normal development, children begin to gain bladder control, usually between the ages of 2-3. Nocturnal urination control is usually completed between the third and fourth years. Involuntary bedwetting at night is defined as enuresis nocturna (EN) in children over 5 years of age without congenital or acquired central nervous system disease. In general, 60% of these children are boys and 40% are girls.
Enuresis nocturna is classified as primary and secondary. While a child with primary enuresis nocturna does not stay dry at all since birth, complaints relapse after a dry period of at least six months in secondary enuresis nocturna. Its incidence is 15-20% at the age of 5 years and around 10% at the age of 7. There is an average of 15% improvement per year. Spontaneous recovery usually occurs around the age of 14-16. With the advancing age, this problem ends at a rate of 99%, but in 1% of the patients, the complaints continue after the age of 17.
The exact cause of this disorder is not clear. Loss of urinary control as a result of deep sleep is the most emphasized issue. Approximately 70-75% of children who wet the bed at night have a first-degree relative who wets the bed at night. It has been observed that if there is a family history of enuresis nocturna, families do not care about the enuresis in their children and expect it to go away on its own, therefore the age of admission is delayed. If patients are older than 5 years of age, treatment should be initiated. Before starting the treatment, it should be investigated whether there is an organic disease of the urinary system. Treatment should proceed step by step.
Step Treatment: Motivation Therapy is behavioral psychotherapy.
Line Therapy: Alarm therapy.
Step Treatment: It is medical (drug) treatment, sometimes alarm treatment can be skipped and drug treatment can be started directly. Its success is 90%, the treatment lasts for 6 months, the probability of recurrence after the drug is stopped is 60%.
