Bed wetting is tolerable upto certain age, but after that it becomes serious concern for parents. If not cured properly, it can affect the personality & thereby growth of the child, as enuresis can give mental trauma.
Defined as normal nearly complete evacuation of bladder at wrong place and time at least twice a month after the fifth year of life. More than 85% of children will have the day and night control by five years of age. The 15% gain full control before adolscence. Only 0.5 to 1% continued to have enuresis. Bed Wetting at night is known as nocturnal enuresis.
Causes
- Primary
- Secondary
Primary
This is defined as repeated (twice a week for at least 3 months) passage of urine into clothes/bed during night in children more or less 5 years who have never been dry at night. This is more common in boys. This can be related to sleep disorder, genetic psychological causes. Less than 3% cases will have the organic causes - such as obstructive uropathy, UTI etc. This can be associated to the -
- Neurological maturation
- Mental retardation
- Spinal cord maturation defect
Secondary Causes
In this case the child who had been dry for several months starts bed wetting again.
Other Causes
- Defective toilet training
- Emotional stress
- Parent child maladjustment
- UTI
- J. Diabetes mellitus
- Diabetes inspidis
Investigation
- Complete urine examination : MIE, Albumin, Sugar, Specific gravity
- Ultrasonography
Treatment
Treatment goal is to stop enuresis.
- Bladder Strengthing exercises
- Hold the urine as long as possible during day times.
- Practice getting up from bed and going to the toilet at bed times; before going to sleep.
- Use of alarm device.
2. Psychological support is very important.
Medicines
- Tricyclic antidepressants like imipramine e.g. Tab Depsonil 25mg to 50mg at bed time.
- Antidiuretic hormone spray (nasal spray) for 3 weeks.
Ayurvedic Medicines
Syrup Santonic 1tsf bd
Syrup Mentat
Role of Acupressor
Pressing a little finger has same role.