bedwetting

What is bedwetting at night? What is the frequency?
Most children between the ages of 2 and 4 are able to hold their urine both day and night. It is often the result of a delay in bladder development, so its frequency decreases with age. Although 40% of three-year-olds wet the bed, this rate drops to 20% at the age of 5 and 10% at the age of 6. Boys have more frequent bedwetting problems than girls.
How many types of bedwetting are there at night, what are the causes?
There are two types of bed-wetting at night. If it has not been dry at all since birth, primary (primary) type is mentioned as secondary (secondary) type bedwetting if it has started to wet the bed after being dry for at least 6 months. The majority of children who wet their beds are in the primary bedwetting group. Sometimes, bedwetting may be accompanied by symptoms such as frequent and urgent need to urinate. Bedwetting at night is divided into two groups, physiological and organic, according to its causes. A large group (90-95%) of children who wet the bed at night gather in the physiological bedwetting group. It has been reported that these children have insufficient feeling of bladder fullness during sleep at night, their bladder capacity is small and their sleep depth is high. Importantly, bedwetting is largely based on genetic predisposition. If one of the parents has a history of bedwetting, the child has a 45% problem, and if both parents have a history of bedwetting, it is 77%. Cases with a family history show a similar course to their families in terms of recovery time.
Which diseases does it accompany?
2-3% of children who wet the bed have problems such as diabetes, kidney diseases and bladder diseases. In 5-10% of the cases, bedwetting is accompanied by complaints such as frequent and urgent need to urinate. These are defined as “polysymptomatic bedwetting”. Urinary tract infection, bacteria in the urine, constipation and sometimes food allergy are detected in these children. In addition, in recent years, it has been emphasized that a high rate of bedwetting is observed in children with adenoid vegatation, which is popularly known as “nasal meatus”, and that their complaints after surgery are gone.
Psychological problems
In general, psychological events do not cause the primary bedwetting problem mentioned earlier. For this reason, there is no need to look for a mental problem in the majority of children who wet the bed. In addition, it should be kept in mind that prejudices such as bad children wet the bed are invalid. If bedwetting occurs after a mental problem, it is usually a reoccurrence of physiological bedwetting. Children with behavioral regression have additional symptoms such as school failure and fear in addition to bed wetting at night, and these must be seen by child psychiatrists.
How to approach?
We should immediately and strongly state that the wrong attitudes of families and society harm these children more than the bed-wetting itself. The most dangerous of these are the attempts to punish sexual areas, which are the subject of news headlines such as “She made her daughter sit on the stove”. Such attitudes leave traces on children that will last a lifetime. It should not be forgotten that children who wet the bed experience a physiological developmental delay (such as a delay in teething, speech delay) and the main task of the family is to ensure that the child’s self-esteem is overcome without damaging it. For this reason, children who wet the bed should be evaluated by a pediatrician at the age of 6 at the latest and a treatment plan should be made after the necessary examinations are made.
What kind of examinations should be done in children who wet the bed?
Children brought to the doctor with the complaint of bedwetting should be examined for the presence of the previously mentioned organic factors. For this, it should be investigated whether there are complaints such as incontinence during the day, difficult urination, constipation, difficult and urgent urination, excessive urination, head trauma, incontinence with urine, snoring and mouth breathing at night. According to the information obtained and the results of the general examination, a series of tests ranging from urine analysis to bladder films should be performed. In 97% of children who wet the bed, there is no physical reason. Therefore, a detailed history often gives information about whether physiological bedwetting is present. At this point, it is important to clarify whether the child who wets the bed has a “small bladder” or not being able to wake up from sleep.
Methods used in the treatment
It is generally recommended that children who wet the bed be treated when they reach the age of 7-8. At the beginning of these initiatives are programs for the child himself or his family to wake up at night. A program is implemented that allows the family to wake the child at night and go to the toilet. This program has achieved 90% success.
Use of alarms in treatment and drug therapy
Alarm devices are tools that act as soon as the child starts to leak urine, thus helping the child wake up and control his bladder. With this treatment, 70-84% improvement is achieved in children. Various drugs have been used for many years in the treatment of bedwetting. There is a recurrence risk of up to 90%.
Bedwetting is a common problem in childhood and is an issue where family misconduct continues. First of all, children who wet the bed should be evaluated by the pediatricians who are interested in the subject and a long-term treatment approach should be tried with the participation of the family.