Enuresis

Alternative names:

bed wetting

Treatment:

Time and patience are the parent's greatest allies. A supportive, helpful attitude by the parents and/or care givers is very important.

The following methods may be helpful:

• behavior modification techniques such as rewards for remaining dry at night (the rewards increase in value as the number of consecutive dry nights increase
• limiting fluids at bedtime (to be effective fluid limitation must be started after dinner but may be difficult to enforce and hard on young children
• alarm devices to wake a child periodically or a bell alarm pad that awakens the child when the pad gets wet

In older children, imipramine may be prescribed, but close observation of the child's response to medication must be maintained. Imipramine may begin to work by the first or second night. Treatment usually lasts 4 to 6 months. Desmopressin (DDAVPa medication that is an analogue of the hormone vasopressin--see the vasopressin test for more information about this hormone) may also be prescribed to reduce urine production throughout the night. DDAVP is effective but more expensive than imipramine.

If the cause of the disorder appears to be emotional, family counseling may provide insights into the problem and recommend appropriate approaches to therapy.

Expectations (prognosis):

The condition poses no threat to the health of the child if there is no physical cause of enuresis. The child may feel embarrassment or have a loss of self-esteem associated with the problem. Most children respond to some type of treatment.

Complications:

Complications may develop if a physical cause of the disorder is overlooked. Psychosocial complications may arise if the problem is not dealt with effectively and in a timely manner.

Calling your health care provider:

Call for an appointment with your child's health care provider if bed wetting occurs (to rule out urinary tract infection or other causes).