What is bedwetting?

Bedwetting also called nighttime incontinence or nocturnal enuresis is involuntary wetting during sleep past an age in which one can reasonably be expected to stay dry at night. Wet sheets, pyjamas, and an awkward child are a common sight in many homes. But don't despair. Bed-wetting is not a sign of poor toilet training. It is frequently a typical aspect of a youngster's turn of events.

In general, bed-wetting before the age of seven is not a concern. At this age, your baby may still develop nighttime bladder control. On the off chance that bed-wetting proceeds, treat the issue with persistence and comprehension. Lifestyle changes, bladder training, humidity alarms, and sometimes medications may help reduce bedwetting.

Symptoms of bedwetting

Most children are fully toilet trained by the age of five, but there is no set date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting stays an issue for certain kids. After 7 years of age, few babies are still bed-wetting.

Causes of bedwetting

Physical and psychological conditions can lead to bedwetting for some people. Common causes of bedwetting include children and adults:

· Small bladder size

· Urinary tract infection (UTI)

· Tension, fear, or insecurity

· Neurological disorders, such as injury after a stroke

· An enlarged prostate gland

· Sleep apnea, or abnormal breathing stops during sleep

· Constipation

Hormonal imbalances can also cause some people to develop bedwetting. The body makes the anti-diuretic hormone (ADH). ADH tells your body to slow urine production overnight. The reduced volume of urine helps the normal bladder to hold urine throughout the night.

People whose bodies do not produce adequate levels of the hormone (ADH) may suffer from nocturnal enuresis because their bladders cannot hold larger amounts of urine.

Diabetes is another disorder that can cause bedwetting. If you have diabetes, your body does not process glucose or sugar properly and may produce larger amounts of urine. Increased urine production can cause children and adults to get wet, who usually stay dry overnight.

Diagnosis of bedwetting

You will know if a child has incontinence if he is older than 6 years old, and he will often wake up on a wet bed. You and your health care provider will want to know the cause of bedwetting.

Your child's paediatrician will ask how often this has happened and other symptoms. Before your Urologist Doctor Appointment, try to track your baby's bathing habits in the bladder diary. Include information such as:

· How often does your child urinate during the day and at night?

· How often does stool pass and how hard or soft is the stool?

· Does your child drink liquids before bed?

If your healthcare provider needs more information, your child may have it:

· Urine culture and urinalysis: Urine tests are used to check for infection, unwanted blood, and other elements in the urine.

· Blood test: Blood tests can check kidney, thyroid, and cholesterol levels and the presence of anemia, diabetes, or hormone problems.

· Bladder examination: This type of ultrasound shows the amount of urine that is still in the bladder after urination.

· Urodynamics test: These tests check to see how well the lower urinary tract stores and excretes urine.

· Cystoscopy: During this test, the doctor inserts a narrow tube with a small lens into the bladder to check for a tumor or other more serious conditions.

Complications of bedwetting

Although frustrating, bed-wetting without a physical cause poses no health risks. However, bed-wetting can cause some problems for your child, including:

· Feelings of guilt and embarrassment, which can lead to low self-esteem

· Missing opportunities for social activities, such as sleeping outside and camping

· The appearance of a rash on the lower part and genital area of the child, especially if your child sleeps in wet underwear

How is bedwetting treated?

If there is no medical reason for bedwetting, your provider can provide advice on managing the condition. Bedwetting can be treated by changing the child's behaviour or with various oral medications (taken by mouth).

What changes can I make to my child’s behaviour or routine to help with bedwetting?

Your health care provider may suggest trying to initiate behavioural changes. Behavioural techniques are changes you can make to your child's nighttime routine that do not include medication. These may include techniques:

· Limit fluids before bed: Don't give your child anything to drink at least two hours before bed. Make sure your child drinks plenty of fluids during the day.

· Going to the bathroom before bed: Make sure your child goes to the bathroom and has completely empty his bladder before going to bed.

· Incontinence alarm: This is a device that makes a loud noise or vibrates to wake the child when he or she starts wetting the bed. It has a wetness sensor that triggers an alarm so the baby can wake up and finish peeing in the bathroom. Over time, the child learns to wake up when he feels the sensation of a full bladder, and eventually he may be able to sleep through the night without needing to urinate. It may take several months for this technique to succeed.

· Bladder therapy: This approach aims to gradually increase the functional capacity of the bladder by having the child wait to go to the bathroom. Increasing the length of time between bathroom visits enlarges the bladder to allow it to hold more urine.

· Counselling: Psychological counselling may be effective in situations where a child has experienced a traumatic event or suffers from low self-esteem due to bedwetting.

What medications can I give my child to help with bedwetting?

The accompanying prescriptions might be utilized alone or in the mix with conduct procedures to treat bedwetting by urologists:

· Desmopressin: This is the human-made version of the hormone vasopressin, which causes the kidneys to produce less urine. It is effective in about half of all cases, with better results in older children who have a normal bladder capacity. The medicine can lower the sodium levels in the children who take it, so you must limit the amount of fluid your child drinks after dinner.

· Oxybutynin: This drug is used to treat an overactive bladder by reducing bladder spasms. It can be used with Desmopressin or the enuresis alarm method. It may be effective for babies who bed-wetting more than once a night and who also have daytime hydration.

· Imipramine: This drug is effective in 40% of cases, but it should be used with caution due to the risk of serious side effects..

Risk factors for bedwetting

Bed-wetting can affect anyone, but it is more common in boys and girls. Several factors have been associated with an increased risk of bed-wetting, including:

· Stress and anxiety: Stressful events such as becoming a brother or sister, starting a new school, or sleeping far from home may lead to bed-wetting.

· Family history: If one or both of the child's parents wet the bed when they were children, their child has a great chance of wetting the bed as well.

· Attention deficit hyperactivity disorder (ADHD): Bed-wetting is more common in children with ADHD.