Bed Wetting

Overview

Bed wetting is the involuntary urination at night in children after the age when control of urine can be reasonably expected. It is a common issue in children as they are still developing nighttime bladder control.

Signs and Symptoms

Bed-wetting before the age of 7 is not a concern, Some children may still wet the bed after the age of 7, Some children may have bed wetting after a long period of good toilet training with dryness

Common Causes

Small or underdeveloped bladder fails to hold urine produced at night, Unable to recognise a full bladder as the nerves controlling the bladder are not matured, Insufficient anti-diuretic hormone (ADH) to slow urine production at night, Urinary tract infection, Obstructive sleep apnea due to inflamed tonsils or adenoids, Diabetes, Chronic constipation causing muscles to become dysfunctional, Structural issues in the urinary system or nervous system

Risk Factors

Family history of bed wetting

Investigation Techniques

Medical history, Physical examination, Urine tests to look for signs of diabetes or urinary tract infection, Ultrasound of the urinary system and voiding cystourethrography to look for structural abnormalities in the urinary system, Magnetic resonance imaging (MRI) of lumbosacral spine for suspected spinal problems, Urodynamic studies to rule out dysfunctional voiding

Treatment and Prevention

Most cases do not require treatment, Avoid caffeine, Limit fluid intake at night, Double void before going to bed, Moisture alarms, Medications such as desmopressin to slow urine production at night or oxybutynin to increase bladder capacity and reduce bladder contractions

Psychological Issues

Attention deficit hyperactivity disorder, Stress, Anxiety