Materiały źródłowe

• #1 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. The condition is characterized by involuntary urination during sleep at least twice a week for 3 months in children older than 5. Enuresis is classified into 2 primary types: monosymptomatic enuresis, where bedwetting is the sole symptom, and non-monosymptomatic enuresis, which includes additional urinary symptoms such as urgency or frequency. […] Initial evaluation includes a detailed history, physical examination, voiding diary, and urinalysis to exclude bladder dysfunction or an underlying medical condition. […] The decision to pursue treatment depends on how disruptive the patient and family perceive the enuresis and their motivation to engage in a treatment program.

• #2 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections. […] Most bedwetting is a developmental delay not an emotional problem or physical illness. Only a small percentage (5 to 10%) of bedwetting cases have a specific medical cause. Bedwetting is commonly associated with a family history of the condition. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis is when a child or adult begins wetting again after having stayed dry. […] Treatments range from behavioral therapy, such as bedwetting alarms, to medication, such as hormone replacement, and even surgery such as urethral dilatation. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control.

• #3 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  The only therapies proved to be effective are alarm therapy and pharmacologic therapy. Enuresis per se is not a surgically treated condition. Treatment is usually not recommended for children younger than 6 or 7 years. […] The International Childrens Continence Society (ICCS) restricts the term enuresis to wetting that occurs at night. Enuresis can be divided into primary enuresis (PE) and secondary enuresis (SE). A child who has never been dry is considered to have PE; a child who has been continent for at least 6 months before the onset of the bedwetting is considered to have SE. […] The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classified both enuresis and encopresis under the heading of elimination disorders. DSM-5 criteria for enuresis are as follows: Repeated voiding of urine into bed or clothes, whether involuntary or intentional.

• #4 Bed-wetting – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/diagnosis-treatment/drc-20366711

  Depending on your child’s situation, the health care professional can check for any underlying cause of bed-wetting. […] A treatment plan can be made based on: Physical exam. […] Discussing symptoms, fluid intake, family history, bowel and bladder habits, and problems caused by bed-wetting. […] Urine tests to check for signs of an infection or diabetes. […] X-rays or other imaging tests of the kidneys or bladder to look at the structure of the urinary tract. […] Other types of urinary tract tests or assessments, if needed. […] If found, underlying causes of bed-wetting, such as constipation or sleep apnea, should be looked into by a health care professional. […] Options for treating bed-wetting may include moisture alarms and medicine. […] If lifestyle changes do not help your child stay dry, your child may be prescribed medicine for a short period of time to stop bed-wetting.

• #5 Nocturnal Enuresis | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0401/p1499.html

  Nocturnal enuresis is a common problem that can be troubling for children and their families. […] The evaluation of nocturnal enuresis requires a thorough history, a complete physical examination, and urinalysis. […] For the diagnosis of nocturnal enuresis to be established, a child five to six years old should have two or more bed-wetting episodes per month, and a child older than six years of age should have one or more wetting episode per month. […] A careful history should be obtained and a thorough physical examination should be performed to look for causes of complicated enuresis in children who present with bed-wetting. […] Parents should be questioned about their family history and the child’s medical history. […] Urinalysis is performed to assess specific gravity and urinary glucose level. It also can determine the presence of infection or blood in the urine. […] If the findings of the physical examination and urinalysis are negative and the history does not suggest a secondary cause of nocturnal enuresis, no further work-up is needed.

• #6 Bedwetting in Children & Teens: Nocturnal Enuresis | National Kidney Foundation

  https://www.kidney.org/kidney-topics/bedwetting-children-teens-nocturnal-enuresis

  Nocturnal enuresis is bedwetting at night, common in kids and teens. It often resolves on its own. Treatments include alarms, meds, and lifestyle changes. […] Bedwetting in this age group could be a sign of a urinary tract infection or other health problems, neurological issues (related to the brain), stress, or other issues. […] It’s important to work with your child’s doctors to find possible causes and solutions. […] Secondary enuresis in older children or teens should be evaluated by a doctor. […] Your child’s doctor will first take a complete medical history and ask about any other urinary symptoms such as the urge to urinate a lot, the need to „run to the bathroom” a lot, or pain or burning while peeing. […] The doctor will ask if either parent wet their bed at night as a child.

• #7 Bedwetting in Children & Teens: Nocturnal Enuresis | National Kidney Foundation

  https://www.kidney.org/kidney-topics/bedwetting-children-teens-nocturnal-enuresis

  Finally, the doctor may ask about stressful events in the child’s life that could be adding to the problem. […] Yes. However, treatment for bedwetting first depends on if it is caused by something like stress, which would need to be managed first. […] Research shows that about half of children who properly use enuretic (bedwetting) alarms will stay dry at night after a few weeks. […] There are only two medicines that have been approved for bedwetting: imipramine and desmopressin. […] It is either treated, or it gets better on its own. If bedwetting has not stopped in the late teens, your child should see a doctor. […] Never wait to talk about bedwetting with your pediatrician to find a solution that works best for your child and your family.

• #8 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  The etiology of NE is not fully understood, although there are three common causes: excessive urine volume, poor sleep arousal, and bladder contractions. Differentiation of cause is mainly based on patient history and fluid charts completed by the parent or carer to inform management options. […] Thorough history regarding frequency of bedwetting, any period of dryness in between, associated daytime symptoms, constipation, and encopresis should be sought. […] Each child should be examined physically at least once at the beginning of treatment. A full pediatric and neurological exam is recommended. Measurement of blood pressure is important to rule out any renal pathology. […] Nocturnal urinary continence is dependent on three factors: 1) nocturnal urine production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms. Any child will experience nocturnal enuresis if more urine is produced than can be contained in the bladder or if the detrusor is hyperactive, provided that he or she is not awakened by the imminent bladder contraction.

• #9 Nocturnal Enuresis | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0401/p1499.html

  Nocturnal enuresis is a common problem that can be troubling for children and their families. […] The evaluation of nocturnal enuresis requires a thorough history, a complete physical examination, and urinalysis. […] For the diagnosis of nocturnal enuresis to be established, a child five to six years old should have two or more bed-wetting episodes per month, and a child older than six years of age should have one or more wetting episode per month. […] A careful history should be obtained and a thorough physical examination should be performed to look for causes of complicated enuresis in children who present with bed-wetting. […] Parents should be questioned about their family history and the child’s medical history. […] Urinalysis is performed to assess specific gravity and urinary glucose level. It also can determine the presence of infection or blood in the urine. […] If the findings of the physical examination and urinalysis are negative and the history does not suggest a secondary cause of nocturnal enuresis, no further work-up is needed.

• #10 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections. […] Most bedwetting is a developmental delay not an emotional problem or physical illness. Only a small percentage (5 to 10%) of bedwetting cases have a specific medical cause. Bedwetting is commonly associated with a family history of the condition. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis is when a child or adult begins wetting again after having stayed dry. […] Treatments range from behavioral therapy, such as bedwetting alarms, to medication, such as hormone replacement, and even surgery such as urethral dilatation. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control.

• #11 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  The only therapies proved to be effective are alarm therapy and pharmacologic therapy. Enuresis per se is not a surgically treated condition. Treatment is usually not recommended for children younger than 6 or 7 years. […] The International Childrens Continence Society (ICCS) restricts the term enuresis to wetting that occurs at night. Enuresis can be divided into primary enuresis (PE) and secondary enuresis (SE). A child who has never been dry is considered to have PE; a child who has been continent for at least 6 months before the onset of the bedwetting is considered to have SE. […] The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classified both enuresis and encopresis under the heading of elimination disorders. DSM-5 criteria for enuresis are as follows: Repeated voiding of urine into bed or clothes, whether involuntary or intentional.

• #12 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. The condition is characterized by involuntary urination during sleep at least twice a week for 3 months in children older than 5. Enuresis is classified into 2 primary types: monosymptomatic enuresis, where bedwetting is the sole symptom, and non-monosymptomatic enuresis, which includes additional urinary symptoms such as urgency or frequency. […] Initial evaluation includes a detailed history, physical examination, voiding diary, and urinalysis to exclude bladder dysfunction or an underlying medical condition. […] The decision to pursue treatment depends on how disruptive the patient and family perceive the enuresis and their motivation to engage in a treatment program.

• #13 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  The etiology of NE is not fully understood, although there are three common causes: excessive urine volume, poor sleep arousal, and bladder contractions. Differentiation of cause is mainly based on patient history and fluid charts completed by the parent or carer to inform management options. […] Thorough history regarding frequency of bedwetting, any period of dryness in between, associated daytime symptoms, constipation, and encopresis should be sought. […] Each child should be examined physically at least once at the beginning of treatment. A full pediatric and neurological exam is recommended. Measurement of blood pressure is important to rule out any renal pathology. […] Nocturnal urinary continence is dependent on three factors: 1) nocturnal urine production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms. Any child will experience nocturnal enuresis if more urine is produced than can be contained in the bladder or if the detrusor is hyperactive, provided that he or she is not awakened by the imminent bladder contraction.

• #14 Bed-wetting – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/diagnosis-treatment/drc-20366711

  Depending on your child’s situation, the health care professional can check for any underlying cause of bed-wetting. […] A treatment plan can be made based on: Physical exam. […] Discussing symptoms, fluid intake, family history, bowel and bladder habits, and problems caused by bed-wetting. […] Urine tests to check for signs of an infection or diabetes. […] X-rays or other imaging tests of the kidneys or bladder to look at the structure of the urinary tract. […] Other types of urinary tract tests or assessments, if needed. […] If found, underlying causes of bed-wetting, such as constipation or sleep apnea, should be looked into by a health care professional. […] Options for treating bed-wetting may include moisture alarms and medicine. […] If lifestyle changes do not help your child stay dry, your child may be prescribed medicine for a short period of time to stop bed-wetting.

• #15 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  The word enuresis is derived from the Greek verb enourein (to void urine). It refers to the act of involuntary urination and can occur either during the day or at night (though some restrict the term to bedwetting that occurs at night only). Enuresis can be divided into primary and secondary forms. Primary enuresis is defined as the patient never having been dry at night; secondary enuresis is defined as the patient having had a period of being dry and then starting to wet. […] If an underlying problem is identified and successfully treated and the enuresis persists, the enuresis should be considered a separate problem. Adverse effects of medications should be considered as possible causes. […] Studies that may be helpful in the workup include the following: Urinalysis (the most important screening test in a child with enuresis) – Ensure that urinalysis is performed on a concentrated urine specimen; dilute specimens with a specific gravity under 1.010 might not reveal infection.

• #16 Patient education: Bedwetting in children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bedwetting-in-children-beyond-the-basics/print

  Bedwetting (also called nighttime or nocturnal enuresis) is a common childhood problem. […] The age at which enuresis is considered a „problem” depends on when the child develops bladder control and the perspective of the caregivers: […] For most children, enuresis is a problem when it interferes with their ability to socialize with friends. However, it is understandable for caregivers to want reassurance that their child’s bedwetting is not caused by an underlying medical problem. […] Urinalysis — Urinalysis is a screening test for underlying medical problems. It requires testing a small sample of a child’s urine. Urinalysis can usually be done in the clinician’s office. […] Most children who have bedwetting do not need further testing or referral. However, a child who has daytime bladder problems or abnormal findings on urinalysis or physical examination may need further testing.

• #17 Understanding Adult Bed-Wetting: Causes, Diagnosis, and Treatment Options for Men Over 50.

  https://www.proudp.com/post/adult-bed-wetting-causes-diagnosis-treatment

  If you’re experiencing this, it’s important to know that it is manageable, and seeking professional medical advice is a key step toward finding a solution. […] When you see your doctor, he or she will perform a number of tests to determine the cause of your bedwetting. Here are some important diagnostic tools that will be used: […] A simple test that analyzes a sample of your urine to check for infections or other conditions affecting the urinary tract. This test helps doctors identify problems with your kidneys, bladder, or urethra that may be contributing to your bedwetting. […] This test involves sending a small sample of your urine to a lab. There, technicians place the urine in a dish with nutrients to see if bacteria or yeast grow. This test is especially useful for diagnosing urinary tract infections, which are a common cause of bedwetting in adults.

• #18 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  The ideal time to treat primary MNE is when the child is motivated, able, and willing to adhere to a treatment program. […] Understanding whether the child’s goal is to stay dry for specific events like sleepovers, reduce the overall frequency of wet nights, or minimize the impact of enuresis on the family is crucial for developing an effective treatment plan. […] Enuresis is most often due to discordance between bladder capacity, nocturnal urine production, and the child not waking to the sensation of a full bladder. Less commonly, enuresis is secondary to an underlying physical, developmental, psychological, or behavioral problem. A thorough history, including a voiding diary, physical examination, and urinalysis, is essential to the initial evaluation to exclude underlying bowel or bladder dysfunction or underlying medical conditions.

• #19

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx

  Nocturnal enuresis, defined as nighttime bedwetting beyond age 5, affects many school-age children and even some teens. […] It’s important to work with your child’s doctors to find possible causes and solutions. […] Primary enuresis is much more common. Secondary enuresis in older children or teens should be evaluated by a doctor. Bedwetting in this age group could be a sign of a urinary tract infection or other health problems, neurological issues (related to the brain), stress, or other issues. […] Your child’s doctor will first take a complete medical history and ask about any other urinary symptoms such as the urge to urinate a lot, the need to „run to the bathroom” a lot, or pain or burning while peeing. […] Yes. However, treatment for bedwetting first depends on if it is caused by something like stress, which would need to be managed first. Overall, children who take an active part in their treatment have a better chance of decreasing or stopping the bedwetting. […] There are only two medications that have been approved for bedwetting: imipramine and desmopressin. […] Bedwetting almost always goes away on its own. Most children will grow out of it by the late teenage years or sooner. Secondary enuresis may go away when the cause is found.

• #20 Patient education: Bedwetting in children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bedwetting-in-children-beyond-the-basics/print

  Bedwetting (also called nighttime or nocturnal enuresis) is a common childhood problem. […] The age at which enuresis is considered a „problem” depends on when the child develops bladder control and the perspective of the caregivers: […] For most children, enuresis is a problem when it interferes with their ability to socialize with friends. However, it is understandable for caregivers to want reassurance that their child’s bedwetting is not caused by an underlying medical problem. […] Urinalysis — Urinalysis is a screening test for underlying medical problems. It requires testing a small sample of a child’s urine. Urinalysis can usually be done in the clinician’s office. […] Most children who have bedwetting do not need further testing or referral. However, a child who has daytime bladder problems or abnormal findings on urinalysis or physical examination may need further testing.

• #21 Bedwetting (Nocturnal Enuresis) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/bedwetting-nocturnal-enuresis

  Nocturnal enuresis, better known as nighttime bedwetting, occurs when a child who is toilet trained cannot hold their urine during sleep, typically wetting their bed once or twice a night. […] In cases where bedwetting is impacting quality of life, or when lifestyle changes are not successful, children may benefit from further evaluation and additional treatments. […] If your child is toilet trained but wetting the bed, it’s a good idea to set up a consultation with a pediatric urologist. […] This can be important to help tailor therapy and ensure that there are no medical or structural problems that may be contributing to or causing the nighttime wetting. […] Here are some additional tests that your doctor may recommend: Urinalysis to check for UTI, diabetes, or abnormal kidney function.

• #22 Bedwetting (Nocturnal Enuresis) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/bedwetting-nocturnal-enuresis

  Renal bladder ultrasound. This imaging examination is used to determine the size and shape of your child’s kidney and bladder, and to detect a mass, stone, cyst, or other obstruction or abnormalities. […] Bedwetting is not harmful to your child in any way other than its impact on self-esteem. […] If your child is embarrassed to attend camp or a sleepover, you may want to talk with your pediatric urologist about some of the following therapies: Behavior modification (for example, no fluids after 6 p.m.). […] Drug therapy that includes DDAVP, which replaces the natural hormone vasopressin.

• #23 Bedwetting: Symptoms, Causes, Treatment and Complications

  https://www.carehospitals.com/diseases-conditions/bedwetting

  Ultrasound: This imaging test provides a detailed view of the kidneys, bladder, and urinary tract, helping identify structural abnormalities. […] Uroflowmetry: This diagnostic test measures the volume and speed of urine flow, providing insights into bladder and urethral function. […] Post-void Residual Urine Measurement: This test checks if the bladder empties completely during urination, […] Overnight Bladder Volume Measurements: These help determine if the bladder is producing too much urine at night. […] Bedwetting is a common issue that affects many individuals, particularly children. […] If bedwetting persists beyond 7. […] If a child experiences a sudden onset of bedwetting after a prolonged period of dry nights […] Adults who experience persistent or recurrent bedwetting should not hesitate to seek medical advice.

• #24 Understanding Adult Bed-Wetting: Causes, Diagnosis, and Treatment Options for Men Over 50.

  https://www.proudp.com/post/adult-bed-wetting-causes-diagnosis-treatment

  During this test, you urinate into a special funnel that measures how much urine you produce and how fast it flows out. This can help doctors assess whether there is a blockage or difficulty emptying the bladder completely, which is often associated with conditions such as BPH. […] In this test, your healthcare provider measures how much urine is left in your bladder after you’ve urinated. This test helps determine if your bladder is emptying completely, as incomplete emptying can lead to bedwetting and other urinary problems. […] If you’re a regular bedwetter, don’t be embarrassed – talk to your healthcare provider. They can help you determine what’s causing the problem and guide you toward effective treatment options. […] Ignoring the problem won’t make it go away, and with the right approach, you can significantly reduce or even eliminate nighttime accidents. […] In conclusion, adult enuresis is a manageable condition. With proper medical evaluation and treatment, you can regain control and improve your quality of life.

• #25 Understanding Adult Bed-Wetting: Causes, Diagnosis, and Treatment Options for Men Over 50.

  https://www.proudp.com/post/adult-bed-wetting-causes-diagnosis-treatment

  During this test, you urinate into a special funnel that measures how much urine you produce and how fast it flows out. This can help doctors assess whether there is a blockage or difficulty emptying the bladder completely, which is often associated with conditions such as BPH. […] In this test, your healthcare provider measures how much urine is left in your bladder after you’ve urinated. This test helps determine if your bladder is emptying completely, as incomplete emptying can lead to bedwetting and other urinary problems. […] If you’re a regular bedwetter, don’t be embarrassed – talk to your healthcare provider. They can help you determine what’s causing the problem and guide you toward effective treatment options. […] Ignoring the problem won’t make it go away, and with the right approach, you can significantly reduce or even eliminate nighttime accidents. […] In conclusion, adult enuresis is a manageable condition. With proper medical evaluation and treatment, you can regain control and improve your quality of life.

• #26 Understanding Adult Bed-Wetting: Causes, Diagnosis, and Treatment Options for Men Over 50.

  https://www.proudp.com/post/adult-bed-wetting-causes-diagnosis-treatment

  During this test, you urinate into a special funnel that measures how much urine you produce and how fast it flows out. This can help doctors assess whether there is a blockage or difficulty emptying the bladder completely, which is often associated with conditions such as BPH. […] In this test, your healthcare provider measures how much urine is left in your bladder after you’ve urinated. This test helps determine if your bladder is emptying completely, as incomplete emptying can lead to bedwetting and other urinary problems. […] If you’re a regular bedwetter, don’t be embarrassed – talk to your healthcare provider. They can help you determine what’s causing the problem and guide you toward effective treatment options. […] Ignoring the problem won’t make it go away, and with the right approach, you can significantly reduce or even eliminate nighttime accidents. […] In conclusion, adult enuresis is a manageable condition. With proper medical evaluation and treatment, you can regain control and improve your quality of life.

• #27 Bedwetting in Children | Health & Harmony Rx

  https://www.healthandharmonyrx.com/bedwetting-in-children.php

  Bedwetting requires medical consultation if it persists after the age of 7, if the child experiences nocturnal incontinence after being dry at night for several months, if the child is unusually thirsty, experiences hard stools, snores or has pain during urination. […] In diagnosing bedwetting, the doctor will check the child through physical examination and a discussion of any unusual stressors, such as starting school, moving, bullying or parental divorce. […] Diagnosis of bedwetting may also involve the following: […] Urine tests to detect or rule out infection or diabetes […] X-rays, CT or MRI scans of the urinary tract […] Blood tests […] Tests for apnea or other sleep disorders. […] If severe constipation is an issue, the doctor may order other diagnostic tests, such as anorectal manometry, colonoscopy or sigmoidoscopy.

• #28 Bed-wetting – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685

  Bed-wetting also called nighttime incontinence or nocturnal enuresis means passing urine without intending to while asleep. This happens after the age at which staying dry at night can be reasonably expected. […] If your child continues to wet the bed, treat the problem with patience and understanding. Lifestyle changes, bladder training, moisture alarms and sometimes medicine may help lessen bed-wetting. […] Most children outgrow bed-wetting on their own but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention. […] Talk to your child’s doctor or other health care professional if: Your child still wets the bed after age 7. Your child starts to wet the bed after a few months of being dry at night. In addition to wetting the bed, your child has pain when passing urine, is often extra thirsty, has pink or red urine, has hard stools, or snores.

• #29 Bedwetting in children: What parents should know about nighttime enuresis – CHOC – Children’s health hub

  https://health.choc.org/bedwetting-in-children-what-parents-should-know/

  Bedwetting is when a child who is old enough to control their bladder loses bladder control – also called urinary incontinence or enuresis – at night. […] Bedwetting or nighttime enuresis has many possible causes, says Dr. Reshmi Basu, a pediatrician in the CHOC Primary Care Network. The cause of nighttime enuresis often is not known. […] The main symptom is when a child age 5 or older wets their bed or their clothes two times a week or more, for at least three months. […] The symptoms of enuresis can seem like other health conditions. Take the child to their healthcare provider for a diagnosis. […] To diagnose the child, the pediatrician will ask about the child’s health history. […] The pediatrician may give the child a physical exam. The child may also need tests, such as urine tests or blood tests. These are done to look for a health problem, such as an infection or diabetes.

• #30 Enuresis – Bed wetting and Monosymptomatic Enuresis

  https://www.rch.org.au/clinicalguide/guideline_index/Enuresis_-_Bed_wetting_and_Monosymptomatic_Enuresis/

  Once dryness is achieved for 2 weeks or more, consider introducing overlearning to over condition the bladder. Encourage the child to drink extra fluids in the hour before bedtime, providing a greater challenge to remaining dry, which may reduce the rate of relapse […] Consider referral to a general paediatrician or continence service when red flags are present […] Persistent enuresis with failure of an enuresis alarm […] Day-time enuresis or combined day/night enuresis after exclusion or treatment of a UTI and constipation […] History of recurrent urinary tract infections […] Comorbidities such as type 1 diabetes, physical or neurological problems […] Substantial psychological or behavioural problems (consider mental health referral, paediatrician and/or child protection services if significant concern exists).

• #31 Bed-wetting – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685

  It’s not known for sure what causes bed-wetting. Several issues may play a role, such as: A small bladder. Your child’s bladder may not be developed enough to hold all the urine made during the night. No awareness of a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child. This may be especially true if your child is a deep sleeper. A hormone imbalance. During childhood, some kids do not produce enough anti-diuretic hormone, also called ADH. ADH slows down how much urine is made during the night. Urinary tract infection. Also called a UTI, this infection can make it hard for your child to control the urge to pass urine. Symptoms may include bed-wetting, daytime accidents, passing urine often, red or pink urine, and pain when passing urine. Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea.

• #32 Bedwetting: Causes, Risk Factors, and Treatments

  https://www.healthline.com/health/bedwetting

  Bedwetting is the loss of bladder control during the night. The medical term for bedwetting is nocturnal (nighttime) enuresis. Bedwetting can be an uncomfortable issue, but in many cases its perfectly normal. […] Bedwetting is a standard developmental stage for some children. However, it can be a symptom of underlying illness or disease in adults. About 2 percent of adults experience bedwetting, which can be attributed to a variety of causes and may require treatment. […] Physical and psychological conditions can lead to some people having bedwetting. Common causes of children and adults having bedwetting include: small bladder size, urinary tract infection (UTI), stress, fear, or insecurity, neurological disorders, such as being post-stroke, prostate gland enlargement, sleep apnea, or abnormal pauses in breathing during sleep, constipation.

• #33 Enuresis Differential Diagnoses

  https://emedicine.medscape.com/article/1014762-differential

  If a medical condition capable of causing the symptoms (eg, neurogenic bladder, diabetes, or urinary tract infection [UTI]) is present, the diagnosis of enuresis generally is not made. However, if urinary incontinence was present on a regular basis before these other medical conditions developed or persisted after they were adequately treated, the diagnosis of enuresis is compatible with their presence. […] In general, the diagnosis of nocturnal enuresis is based on excluding all other possible causes.

• #34 Enuresis (Bedwetting) Specialists | Nemours Children’s Health

  https://www.nemours.org/services/bedwetting.html

  Enuresis, also known as bedwetting, is the medical name for not being able to control your urine (pee). […] We provide comprehensive evaluation and management of urinary incontinence in kids (trouble holding or releasing urine or stool), including problems with daytime wetting, urinary urgency and frequency, and nighttime bedwetting. […] Our Continence Clinic offers diagnosis and treatment for kids with problems holding or releasing urine or stool (poop).

• #35 Enuresis Differential Diagnoses

  https://emedicine.medscape.com/article/1014762-differential

  If a medical condition capable of causing the symptoms (eg, neurogenic bladder, diabetes, or urinary tract infection [UTI]) is present, the diagnosis of enuresis generally is not made. However, if urinary incontinence was present on a regular basis before these other medical conditions developed or persisted after they were adequately treated, the diagnosis of enuresis is compatible with their presence. […] In general, the diagnosis of nocturnal enuresis is based on excluding all other possible causes.

• #36 Pediatric Bedwetting (Nocturnal Enuresis) | Memorial Hermann

  https://memorialhermann.org/services/conditions/pediatric-bedwetting

  Nocturnal enuresis (bedwetting) is very common in the first few years after toilet training and most children outgrow their bedwetting as this survey of 1265 children in New Zealand shows: […] Some bedwetters do not produce the normal high levels of vasopressin (a hormone that helps recycle water from urine) at night and therefore make more dilute urine than they should at night. In addition, they don’t seem to get the message that the bladder is full and as a result have accidents when asleep. […] Bedwetting can be a symptom of urinary tract infection or abnormalities of the urinary tract and, if associated with painful urination, stream abnormality, or daytime incontinence, should be fully evaluated. Usually a diagnosis of isolated bed-wetting can be made after performing a careful history, physical examination, and inspection of the urine (and, in some situations, ultrasound or other imaging tests).

• #37

  https://bpac.org.nz/bpj/2008/june/enuresis.aspx

  A recent Chinese study included ultrasound examination of 500 children with nocturnal enuresis and showed a reduced functional bladder capacity in approximately 40% of children with nocturnal enuresis. […] Sleep and arousal is one of the least understood factors in the pathophysiology of enuresis. […] Psychological problems are rarely the cause of primary nocturnal enuresis but teasing, bullying or punishment can be the result of it. […] Genetic factors are strongly implicated in the etiology of primary nocturnal enuresis, so it is worthwhile taking a family history of bedwetting. […] When a child presents with bedwetting, enquire about the presence of daytime symptoms, which could indicate that the bedwetting is secondary to other causes. […] The examination of the abdomen, perineum, spine and nervous system is normal in a child with nocturnal enuresis.

• #38 Can Bed-Wetting Be a Sign of Diabetes?- Gluroo

  https://gluroo.com/blog/diabetes-101/bed-wetting-diabetes/

  If this is the case, then bed-wetting could be one of the earliest signs of diabetes in children. The increased urination caused by diabetes could make a child start bed-wetting again. […] Unfortunately, bed-wetting can also be due to an underlying medical condition, and that could be type 1 diabetes. […] Bed-wetting alone may not be a sign of diabetes, but combined with any of the above-mentioned symptoms, diabetes could be the cause. […] Type 1 diabetes is indeed a possible scenario, especially if accompanied by symptoms such as increased thirst and fatigue.

• #39

  https://bpac.org.nz/bpj/2008/june/enuresis.aspx

  Nocturnal enuresis, or bedwetting, is a common condition which children usually grow out of. […] The use of bed alarms with support offers the best chance of long-term success. […] The occasional, short-term use of desmopressin is also discussed. […] Most management strategies are aimed at children aged seven years or older, as this is when bedwetting is usually considered to be a problem by both the child and their family. […] Spontaneous remission occurs in about 15% of affected children each year and is more likely to occur if there is a family history of nocturnal enuresis. […] The exact cause of nocturnal enuresis is unknown. […] Nocturnal polyuria can result from a deranged circadian rhythm of antidiuretic hormone (ADH) secretion which occurs in approximately 70% of children with bedwetting.

• #40 Bedwetting: Causes, Risk Factors, and Treatments

  https://www.healthline.com/health/bedwetting

  Hormonal imbalances can also cause some people to experience bedwetting. […] People whose bodies dont make sufficient levels of ADH may experience nocturnal enuresis because their bladders cant hold higher volumes of urine. […] Diabetes is another disorder that can cause bedwetting. If you have diabetes, your body doesnt process glucose, or sugar, properly and may produce larger amounts of urine. The increase in urine production can cause children and adults who normally stay dry overnight to wet the bed. […] Bedwetting that stems from a medical condition requires treatment beyond just lifestyle adjustments. Medications can treat a variety of conditions of which bedwetting is a symptom. […] Its also important to control chronic conditions, such as diabetes and sleep apnea. Bedwetting associated with underlying medical issues will likely resolve with proper management.

• #41 Bed-wetting – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685

  It’s not known for sure what causes bed-wetting. Several issues may play a role, such as: A small bladder. Your child’s bladder may not be developed enough to hold all the urine made during the night. No awareness of a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child. This may be especially true if your child is a deep sleeper. A hormone imbalance. During childhood, some kids do not produce enough anti-diuretic hormone, also called ADH. ADH slows down how much urine is made during the night. Urinary tract infection. Also called a UTI, this infection can make it hard for your child to control the urge to pass urine. Symptoms may include bed-wetting, daytime accidents, passing urine often, red or pink urine, and pain when passing urine. Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea.

• #42 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  The etiology of NE is not fully understood, although there are three common causes: excessive urine volume, poor sleep arousal, and bladder contractions. Differentiation of cause is mainly based on patient history and fluid charts completed by the parent or carer to inform management options. […] Thorough history regarding frequency of bedwetting, any period of dryness in between, associated daytime symptoms, constipation, and encopresis should be sought. […] Each child should be examined physically at least once at the beginning of treatment. A full pediatric and neurological exam is recommended. Measurement of blood pressure is important to rule out any renal pathology. […] Nocturnal urinary continence is dependent on three factors: 1) nocturnal urine production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms. Any child will experience nocturnal enuresis if more urine is produced than can be contained in the bladder or if the detrusor is hyperactive, provided that he or she is not awakened by the imminent bladder contraction.

• #43 Bedwetting | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bedwetting

  Bedwetting is common in young children and is part of their physical and emotional development. […] Most children stop bedwetting as they grow older. […] A relapse of bedwetting can be a sign of stress in children. […] Bedwetting is a very common condition. One in five preschoolers and around five per cent of all children under the age of ten years still wet the bed. […] Bedwetting isnt a disease, a psychological problem or a response to allergies. […] Some children develop urinary control a little later than others. […] If your child has been dry at night for some time and suddenly starts wetting the bed again, this could be a sign of stress. […] Children commonly wet the bed during times of emotional upheaval, such as divorce, death or the addition of a new baby to the family. […] Sometimes children who have been dry for some time relapse for no apparent reason and no source of stress can be identified. […] If it persists, treatment may need to be started again.

• #44 Child Bedwetting: Causes of Primary and Secondary Bedwetting

  https://www.webmd.com/sleep-disorders/bedwetting-causes

  Bedwetting, or nocturnal enuresis, happens when someone accidentally pees while sleeping. It’s common in kids, even if they’ve been toilet trained. Your child will likely stop wetting the bed around 4 to 6 years old. […] While bedwetting can be a symptom of an underlying disease, most children who wet the bed have no underlying disease that explains their bedwetting. An underlying condition is found in only about 1% of children who routinely wet the bed. […] Bedwetting is most often a developmental issue. Most kids simply outgrow it and never need treatment. […] Bedwetting is quite common in children who have attention deficit hyperactivity disorder (ADHD). Kids with ADHD are three times as likely to have trouble with bedwetting than those who don’t. […] If your child has autism spectrum disorder (ASD), they might also be more likely to wet the bed.

• #45 Child Bedwetting: Causes of Primary and Secondary Bedwetting

  https://www.webmd.com/sleep-disorders/bedwetting-causes

  Bedwetting, or nocturnal enuresis, happens when someone accidentally pees while sleeping. It’s common in kids, even if they’ve been toilet trained. Your child will likely stop wetting the bed around 4 to 6 years old. […] While bedwetting can be a symptom of an underlying disease, most children who wet the bed have no underlying disease that explains their bedwetting. An underlying condition is found in only about 1% of children who routinely wet the bed. […] Bedwetting is most often a developmental issue. Most kids simply outgrow it and never need treatment. […] Bedwetting is quite common in children who have attention deficit hyperactivity disorder (ADHD). Kids with ADHD are three times as likely to have trouble with bedwetting than those who don’t. […] If your child has autism spectrum disorder (ASD), they might also be more likely to wet the bed.

• #46 Enuresis – Bed wetting and Monosymptomatic Enuresis

  https://www.rch.org.au/clinicalguide/guideline_index/Enuresis_-_Bed_wetting_and_Monosymptomatic_Enuresis/

  Dipstick urinalysis is not required in primary enuresis. Consider if red flags apparent. Further imaging or blood tests are not routinely recommended in enuresis […] Constipation, if present, should be adequately managed before addressing enuresis […] Advise on normal bladder function and the pathogenesis of enuresis, including the genetic tendency. Also, that this is a common problem effecting their peer group and they should not be embarrassed […] Bedwetting alarms are available for hire from selected pharmacies, community continence services, tertiary centres, and private practitioners. The Continence Foundation of Australia has a list of service providers […] Children should be in charge of their alarm and may need to be woken initially to turn the alarm off themselves. It is critical for success of alarm therapy that the child is fully awake during the process of going to the bathroom

• #47 Enuresis: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/mental-health/enuresis

  Enuresis is more commonly known as bed-wetting. […] This behavior may or may not be purposeful. The condition is not diagnosed unless the child is 5 years or older. […] Enuresis also may be associated with certain medicines that can cause confusion or changes in behavior as a side effect. If no physical cause is found, the doctor will base a diagnosis of enuresis on the child’s symptoms and current behaviors. […] Treatment may not be needed for mild cases of enuresis, because most children with this condition outgrow it (usually by the time they become teens). […] When treatment is used, therapy aimed at changing behavior is most often recommended. […] Medications are available to treat enuresis, but they generally are only used if the disorder interferes with the child’s functioning and usually are not recommended for children under 6 years of age. […] While drugs can be useful for managing the symptoms of enuresis, once they are stopped, the child typically begins wetting again. […] Most children with enuresis outgrow the disorder by the time they reach their teen years, with a spontaneous cure rate of 12% to 15% per year.

• #48 Pediatric Bedwetting Causes And Treatments – National Association For Continence

  https://nafc.org/pediatric-bedwetting/

  While not a serious medical disorder, bedwetting can have far-reaching effects on both the child and the family. […] Bedwetting occurs because of a delay in learning one or both of these skills. […] Although there are many factors that contribute to nocturnal enuresis, most children do not have a disease process that explains their bedwetting. […] If one parent wet the bed as a child, their child is 44% more likely to do so as well. […] The most important aspect of treatment is determining if the child is motivated to become dry. […] Bedwetting is neither the fault of the child nor the parent. No one should feel ashamed or embarrassed. What is key is to speak with your physician and develop a plan to resolve this issue.

• #49 Child Bedwetting: Causes of Primary and Secondary Bedwetting

  https://www.webmd.com/sleep-disorders/bedwetting-causes

  Bedwetting does tend to run in families. Many children who wet the bed have a parent who did too. […] About 40% of 3-year-olds wet the bed. […] The range is very wide regarding bedwetting. Typically, a child becomes toilet trained between ages 2 and 4. […] If your child has been dry and then starts to wet the bed, tell your pediatrician right away. […] In some cases, you may need medication to help with bedwetting. […] Beware of devices or other treatments that promise a quick „cure” for bedwetting. There really is no such thing. Stopping bedwetting for most children takes patience, motivation, and time. […] Parents should consider treatment if their child is still wetting the bed between ages 6 and 7, according to the National Enuresis Society — or sooner if the child seems troubled by bedwetting.

• #50 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. The condition is characterized by involuntary urination during sleep at least twice a week for 3 months in children older than 5. Enuresis is classified into 2 primary types: monosymptomatic enuresis, where bedwetting is the sole symptom, and non-monosymptomatic enuresis, which includes additional urinary symptoms such as urgency or frequency. […] Initial evaluation includes a detailed history, physical examination, voiding diary, and urinalysis to exclude bladder dysfunction or an underlying medical condition. […] The decision to pursue treatment depends on how disruptive the patient and family perceive the enuresis and their motivation to engage in a treatment program.

• #51 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  The ideal time to treat primary MNE is when the child is motivated, able, and willing to adhere to a treatment program. […] Understanding whether the child’s goal is to stay dry for specific events like sleepovers, reduce the overall frequency of wet nights, or minimize the impact of enuresis on the family is crucial for developing an effective treatment plan. […] Enuresis is most often due to discordance between bladder capacity, nocturnal urine production, and the child not waking to the sensation of a full bladder. Less commonly, enuresis is secondary to an underlying physical, developmental, psychological, or behavioral problem. A thorough history, including a voiding diary, physical examination, and urinalysis, is essential to the initial evaluation to exclude underlying bowel or bladder dysfunction or underlying medical conditions.

• #52 Enuresis (Bed Wetting) | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/nighttime-wetting/

  A complete medical history is obtained at a visit to the Urology Clinic through discussion with the parent and child. We identify motivating factors for becoming dry, as well as individual development, which can play a role in success in treatment. […] There is no single treatment that has been proven to treat nighttime wetting. Treatment often requires multiple interventions and it is not guaranteed that it will work for every child. […] Our Bedwetting and Enuresis (BE) Program was created to specifically address children with wetting issues, including nighttime wetting. We educate on the cause of the condition, as well as behavioral modifications and motivating techniques to help gain success. […] The Urology Department works closely with a clinical psychologist to help address any long-term social issues which can result from bedwetting. Our urology team is committed to helping you and your child attain success with the interventions and become dry at night.

• #53 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  The ideal time to treat primary MNE is when the child is motivated, able, and willing to adhere to a treatment program. […] Understanding whether the child’s goal is to stay dry for specific events like sleepovers, reduce the overall frequency of wet nights, or minimize the impact of enuresis on the family is crucial for developing an effective treatment plan. […] Enuresis is most often due to discordance between bladder capacity, nocturnal urine production, and the child not waking to the sensation of a full bladder. Less commonly, enuresis is secondary to an underlying physical, developmental, psychological, or behavioral problem. A thorough history, including a voiding diary, physical examination, and urinalysis, is essential to the initial evaluation to exclude underlying bowel or bladder dysfunction or underlying medical conditions.

• #54 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Bedwetting is the most common childhood complaint. […] A review of medical literature shows doctors consistently stressing that a bedwetting child is not at fault for the situation. Many medical studies state that the psychological impacts of bedwetting are more important than the physical considerations. „It is often the child’s and family members’ reaction to bedwetting that determines whether it is a problem or not.” […] Whether bedwetting causes low self-esteem remains a subject of debate, but several studies have found that self-esteem improved with management of the condition. […] Bedwetters face problems ranging from being teased by siblings, being punished by parents, the embarrassment of still having to wear diapers, and being afraid that friends will find out. […] Medical literature states, and studies show, that punishing or shaming a child for bedwetting will frequently make the situation worse. It is best described as a downward cycle, where a child punished for bedwetting feels shame and a loss of self-confidence. This can cause increased bedwetting incidents, leading to more punishment and shaming.

• #55 Enuresis (Bed Wetting) | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/nighttime-wetting/

  A complete medical history is obtained at a visit to the Urology Clinic through discussion with the parent and child. We identify motivating factors for becoming dry, as well as individual development, which can play a role in success in treatment. […] There is no single treatment that has been proven to treat nighttime wetting. Treatment often requires multiple interventions and it is not guaranteed that it will work for every child. […] Our Bedwetting and Enuresis (BE) Program was created to specifically address children with wetting issues, including nighttime wetting. We educate on the cause of the condition, as well as behavioral modifications and motivating techniques to help gain success. […] The Urology Department works closely with a clinical psychologist to help address any long-term social issues which can result from bedwetting. Our urology team is committed to helping you and your child attain success with the interventions and become dry at night.

• #56 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Bedwetting is the most common childhood complaint. […] A review of medical literature shows doctors consistently stressing that a bedwetting child is not at fault for the situation. Many medical studies state that the psychological impacts of bedwetting are more important than the physical considerations. „It is often the child’s and family members’ reaction to bedwetting that determines whether it is a problem or not.” […] Whether bedwetting causes low self-esteem remains a subject of debate, but several studies have found that self-esteem improved with management of the condition. […] Bedwetters face problems ranging from being teased by siblings, being punished by parents, the embarrassment of still having to wear diapers, and being afraid that friends will find out. […] Medical literature states, and studies show, that punishing or shaming a child for bedwetting will frequently make the situation worse. It is best described as a downward cycle, where a child punished for bedwetting feels shame and a loss of self-confidence. This can cause increased bedwetting incidents, leading to more punishment and shaming.

• #57 Enuresis – Bed wetting and Monosymptomatic Enuresis

  https://www.rch.org.au/clinicalguide/guideline_index/Enuresis_-_Bed_wetting_and_Monosymptomatic_Enuresis/

  Once dryness is achieved for 2 weeks or more, consider introducing overlearning to over condition the bladder. Encourage the child to drink extra fluids in the hour before bedtime, providing a greater challenge to remaining dry, which may reduce the rate of relapse […] Consider referral to a general paediatrician or continence service when red flags are present […] Persistent enuresis with failure of an enuresis alarm […] Day-time enuresis or combined day/night enuresis after exclusion or treatment of a UTI and constipation […] History of recurrent urinary tract infections […] Comorbidities such as type 1 diabetes, physical or neurological problems […] Substantial psychological or behavioural problems (consider mental health referral, paediatrician and/or child protection services if significant concern exists).

• #58 Enuresis – Bed wetting and Monosymptomatic Enuresis

  https://www.rch.org.au/clinicalguide/guideline_index/Enuresis_-_Bed_wetting_and_Monosymptomatic_Enuresis/

  Once dryness is achieved for 2 weeks or more, consider introducing overlearning to over condition the bladder. Encourage the child to drink extra fluids in the hour before bedtime, providing a greater challenge to remaining dry, which may reduce the rate of relapse […] Consider referral to a general paediatrician or continence service when red flags are present […] Persistent enuresis with failure of an enuresis alarm […] Day-time enuresis or combined day/night enuresis after exclusion or treatment of a UTI and constipation […] History of recurrent urinary tract infections […] Comorbidities such as type 1 diabetes, physical or neurological problems […] Substantial psychological or behavioural problems (consider mental health referral, paediatrician and/or child protection services if significant concern exists).

• #59 Evaluation and Treatment of Enuresis | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0815/p489.html

  Enuresis is defined as repeated, spontaneous voiding of urine during sleep in a child five years or older. It affects 5 to 7 million children in the United States. A diagnosis usually can be made with a history focusing on enuresis and a physical examination followed by urinalysis. […] Primary nocturnal enuresis almost always resolves spontaneously over time. Treatment should be delayed until the child is able and willing to adhere to the treatment program; medications are rarely indicated in children younger than seven years. […] Enuresis alarms are effective in children with primary nocturnal enuresis and should be considered for older, motivated children from cooperative families when behavioral measures are unsuccessful. Desmopressin is most effective in children with nocturnal polyuria and normal bladder capacity.

• #60 Evaluation and Treatment of Enuresis | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0815/p489.html

  Most children with primary nocturnal enuresis require only an enuresis-focused history, physical examination, and urinalysis before initiation of treatment; imaging and urodynamic studies are rarely needed. […] If primary nocturnal enuresis is not distressing to the child, treatment is not needed. However, parents should be reassured about their child’s physical and emotional health and counseled about eliminating guilt, shame, and punishment. […] Medication should be initiated in children seven years and older only if nonpharmacologic measures fail. Children who do not respond to one or more measures may benefit from combined treatment strategies. […] Pharmacologic therapies are not curative, but they decrease the frequency of enuresis or temporarily resolve symptoms over time until spontaneous resolution occurs. Options include anticholinergic agents, tricyclic antidepressants, and desmopressin.

• #61 Evaluation and Treatment of Enuresis | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0815/p489.html

  Most children with primary nocturnal enuresis require only an enuresis-focused history, physical examination, and urinalysis before initiation of treatment; imaging and urodynamic studies are rarely needed. […] If primary nocturnal enuresis is not distressing to the child, treatment is not needed. However, parents should be reassured about their child’s physical and emotional health and counseled about eliminating guilt, shame, and punishment. […] Medication should be initiated in children seven years and older only if nonpharmacologic measures fail. Children who do not respond to one or more measures may benefit from combined treatment strategies. […] Pharmacologic therapies are not curative, but they decrease the frequency of enuresis or temporarily resolve symptoms over time until spontaneous resolution occurs. Options include anticholinergic agents, tricyclic antidepressants, and desmopressin.

• #62 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections. […] Most bedwetting is a developmental delay not an emotional problem or physical illness. Only a small percentage (5 to 10%) of bedwetting cases have a specific medical cause. Bedwetting is commonly associated with a family history of the condition. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis is when a child or adult begins wetting again after having stayed dry. […] Treatments range from behavioral therapy, such as bedwetting alarms, to medication, such as hormone replacement, and even surgery such as urethral dilatation. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control.

• #63 Adult Bed Wetting (Nocturnal Enuresis): Treatment and Causes

  https://www.healthline.com/health/adult-bed-wetting

  Bed-wetting is often associated with childhood. […] Research suggests bed-wetting occurs in 1 to 2 percent of adults. […] Persistent and frequent enuresis, however, is cause for concern and merits a talk with your doctor. […] Diagnosing cancer may require a physical exam, as well as some imaging tests. […] Before a doctor will diagnosis unspecified nocturnal enuresis, theyll conduct several exams and tests to rule out other possible causes. […] If youre an adult experiencing frequent bed-wetting, this may be a sign of an underlying issue or problem. […] The doctor may order a series of tests to look for an underlying cause.

• #64 Why Do Adults Pee the Bed Sometimes?

  https://www.verywellhealth.com/adult-bedwetting-5216129

  Nocturnal enuresis may be a symptom of bladder control issues, or it could be a sign of a more serious condition, like diabetes, kidney disease, or an issue with the urinary tract or nervous system. Thus, it’s important to seek medical care as soon as you notice bedwetting episodes. […] Bedwetting (nocturnal enuresis) in adults may be a sign of an underlying health condition. Nighttime accidents can be due to urinary tract problems, diabetes, sleep apnea, Parkinson’s disease, hormones, and certain medications, and should be assessed by a healthcare provider.

• #65 Causes of Bedwetting in Adults: Diagnosis and Treatment Options

  https://www.soundsleephealth.com/causes-of-bedwetting-in-adults-diagnosis-and-treatment-options/

  Bedwetting in adults differs from bedwetting in children in a couple of important ways. […] Second, childhood bedwetting is considered an indicator of developmental problems with the bladder itself, whereas bedwetting in adults suggests an underlying medical condition that requires medical evaluation and, potentially, treatment. […] Adult patients need to be encouraged to be open about this condition and to be aware that their issues with urinary incontinence at night are not typically voluntary or the result of personal weakness on their part. […] A sleep study can quickly rule in (or rule out) OSA as the root cause of their enuresis. […] Once the OSA is identified and treated, usually with continuous positive airway pressure (CPAP), the bedwetting tends to resolve as well. […] Several tests can be conducted to try to establish the root cause of bedwetting in adults: Neurological assessment, Physical examination with medical and family history, Polysomnogram to rule out OSA, Post-void residual urine measurement, Urinalysis and urine culture, Uroflowometry, Ultrasound of kidneys and the bladder.

• #66 Causes of Bedwetting in Adults: Diagnosis and Treatment Options

  https://www.soundsleephealth.com/causes-of-bedwetting-in-adults-diagnosis-and-treatment-options/

  Bedwetting in adults differs from bedwetting in children in a couple of important ways. […] Second, childhood bedwetting is considered an indicator of developmental problems with the bladder itself, whereas bedwetting in adults suggests an underlying medical condition that requires medical evaluation and, potentially, treatment. […] Adult patients need to be encouraged to be open about this condition and to be aware that their issues with urinary incontinence at night are not typically voluntary or the result of personal weakness on their part. […] A sleep study can quickly rule in (or rule out) OSA as the root cause of their enuresis. […] Once the OSA is identified and treated, usually with continuous positive airway pressure (CPAP), the bedwetting tends to resolve as well. […] Several tests can be conducted to try to establish the root cause of bedwetting in adults: Neurological assessment, Physical examination with medical and family history, Polysomnogram to rule out OSA, Post-void residual urine measurement, Urinalysis and urine culture, Uroflowometry, Ultrasound of kidneys and the bladder.

• #67 Causes of Bedwetting in Adults: Diagnosis and Treatment Options

  https://www.soundsleephealth.com/causes-of-bedwetting-in-adults-diagnosis-and-treatment-options/

  Medical treatments for sleep enuresis include: Anticholinergic drugs for bladder irritation, Antibiotics to treat UTIs, Darifenacin to relieve spastic bladder, Desmopressin acetate to increase ADH levels, DHT-blocking medications to reduce prostate swelling, Oxybutynin or tolterodine to relax the detrusor muscle, Positive airway pressure (PAP) therapy (if OSA is diagnosed), Insulin and glucose management therapies (if diabetes is diagnosed), Improved treatment compliance for patients with preexisting OSA or diabetes. […] The reason why an adult might have bedwetting as a symptom for OSA isn’t well understood, and there may be multiple factors involved. […] Regardless, there exist enough well-known markers for OSA to consider assessing for this sleep disorder in patients with complaints of bedwetting. […] The bottom line? If your adult patient complains of enuresis and exhibits classic symptoms and signs of OSA, you are best advised to refer them for a sleep study, which could yield not only a diagnosis, but an effective treatment for both problems.

Zobacz więcej