Urination, bed wetting

Alternative names:

enuresis

Home care:

Don't worry about bed wetting in children before the age of six.

Don't punish a child who wets. Normal bed wetting is not due to laziness or noncompliance. It can lead to poor self-esteem and feelings of low self-worth. Reassure, encourage, and express confidence in the child.

Withholding bedtime drinks may be helpful, in some children by decreasing the volume of enuresis, but does not prevent the frequency of the problem. Avoiding caffeine-containing drinks may help decrease the amount of urine in the bladder (caffeine increases urine production).

See the health care provider about the use of alarm systems (such as Wet-stop or Enuretone), or drugs like Tofranil (imipramine) or DDAVP nasal spray.

Call your health care provider if:

• there have been repeated episodes of bed wetting after the age of 6.

What to expect at your health care provider's office:

A medical history will be obtained from the patient and the patient's parents (if the patient is a child).

Medical history questions documenting the bed wetting in detail may include:

• time pattern
  • When did bed wetting begin?
  • How often does bed wetting occur?
  • Have there ever been "dry" periods before?
• quality
  • How often is daytime urination?
  • Is control of urine while awake a problem?
  • Does bed wetting cause awakening?
  • How is the bed wetting treated within the family?
  • Is the bed wetting punished?
  • Are other family members aware of the problem?
  • Does the bed wetting cause shame?
• aggravating factors
  • What makes the problem worse?
  • Does the bed wetting increase in times of stress?
  • Is there a urinary tract infection present?
  • Do beverages used contain caffeine or alcohol?
• relieving factors
  • Is there anything that reduces the problem?
• other
  • What other symptoms are also present?
    • fever
    • abdominal pain
    • back pain
    • pain or burning when urinating
  • What medications are being taken?
  • Have other family members had this problem?
  • Is there a family history of diabetes?
  • Is bowel control a problem?
  • Is sensation of the need to urinate present?
  • What methods of prevention have been tried?
    • rewards
    • diapers
    • alarm systems
    • periodic waking
    • restricting fluids

A complete examination will be performed, with emphasis on the abdomen, rectum, and the urinary opening. The health care provider will discuss the options available for treatment.

Diagnostic tests that may be performed include:

• urinalysis
• urine culture
• urodynamic studies

After seeing your health care provider:
If a diagnosis was made by your health care provider related to bed wetting, you may want to note that diagnosis in your personal medical record.

Update Date: 02/09/00
Updated by: J. Gordon Lambert, MD, Associate Medical Director, Utah Health Informatics and adam.com editorial