What Is Enuresis?
Enuresis is the medical term used for involuntary urination. It refers to nocturnal bedwetting. There are not only environmental factors but also physiological factors affecting the condition of children. If the problem persists into maturity, it might have a negative psychological impact on the child. Additionally, sometimes, enuresis can be related to other diseases or disabilities. Usually, nighttime bed-wetters are heavy sleepers who fail to recognize the body’s urge to empty the bladder during sleep. Also, boys around five face this issue more than girls at the same age. The bladder voiding pattern varies day and night, and this issue can be managed with proper treatment.
Predominantly, it is believed that bed-wetting is an issue only little children face, but 1 or 2 out of every 100 teens face the same issue. Anatomically, the bladder is voluntarily controlled by the muscles that hold the urine. The bladder swells when it fills with pee and shrinks when it empties. Muscles control the whole process, but the nerves in the bladder send the message to the brain that it is now filled with urine, and then the brain sends back the signal about contraction and emptying. Sometimes, for various biological reasons, children's brains fail to pick up the signal, which results in bedwetting episodes.
Bladder incontinence is of six types, and young ones might suffer from one or more:
Nighttime Enuresis: It is also known as nocturnal enuresis. The most common type of enuresis occurs at night.
Daytime Enuresis: During the day, a child faces this issue.
Primary Enuresis: In this case, the child cannot control the bladder.
Secondary Enuresis: Almost after six months of control, the child loses control over the bladder.
Monosymptomatic Enuresis: There are no visible urinary tract symptoms or history of bladder dysfunction except nocturia.
Nonmonosymptomatic Enuresis: There are visible urinary tract symptoms such as straining, urgency, increased or decreased frequency, and daytime wetting.
What Are the Etiological Factors Behind Enuresis?
There Are Many Causes Behind the Issue:
Hormonal Issues: Antidiuretic hormone (ADH) plays an important role in urine formation, and a lack of the hormone may cause excessive urine formation while sleeping.
Bladder Issue: The bladder size and amount of muscle limit the bladder capacity.
Genetical Problems: If either of the parents had the same issue during their childhood, there are chances that the child has the same.
Sleep: Deep sleep can be one of the reasons behind this issue.
Caffeine: Caffeinated beverage consumption before bed may cause excessive urine formation.
Medical Condition: Medical conditions like diabetes can cause uncontrollable urine formation.
Psychological Problems: Psychological changes in children, like stress, anxiety, fear, or sadness, can be the reason behind bed-wetting.
Obstructive Sleep Apnea: A child suffering from sleep apnea tends to have insufficient sleep, which can be tiring. Owing to tiredness, the child does not realize the urge to urinate.
Urinary Tract Infection (UTI): When a child suffers from this type of infection, one of the symptoms he feels is false urgency or frequent urination.
What Are the Signs and Symptoms?
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Wetting in the clothes.
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Repeated bed-wetting.
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The incidence of bed wetting continues twice a week for three consecutive months.
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Bladder voiding pattern during daytime.
How to Stop a Baby Boy From Peeing Through a Diaper?
Make sure the diaper is just the right amount snug. If it is too loose, leaks are more likely. Sometimes, a different diaper size might be necessary for better coverage during the night. Opt for high-absorbency diapers designed for overnight use. These diapers are often more effective in retaining moisture and preventing leaks. Ensure the penis is pointing downward before fastening the diaper.
This can help direct the flow and prevent leaks from the top of the diaper. Consider using two diapers for extra protection. Place the second diaper slightly lower or in a different orientation, to enhance coverage. If a baby boy tends to wet heavily during the night, consider changing diapers once midway through the night to prevent leaks caused by over-saturation.
Adjust the baby's liquid intake in the hours leading up to bedtime. A smaller amount of liquid before sleep might reduce the chances of heavy wetting. To safeguard against leaks reaching the bed, use waterproof mattress protectors or layered sheets that can be easily changed if accidents occur.
What Are Diagnostic Measures?
The very first diagnostic measure for enuresis is the observation of sleep patterns. Also, doctors usually ask for medical and family history to get to the root of the problem.
Additionally, other tests need to be done to diagnose the issue:
Urine Test: To evaluate if there is an underlying infection or condition there.
Blood Pressure Measurement: Increased salt consumption and elevated blood pressure have been linked to enuresis.
Blood Tests: This diagnostic method checks for any deficiency or infection associated with the condition.
History: Demographic, medical, and family history are essential for any condition or disease.
Physical Examination: Abdominal examination to check for kidney enlargement or genital or rectal examination to rule out other complications.
Ultrasonography or Magnetic Resonance Imaging (MRI): To see any structural abnormality of the organ.
How to Manage Enuresis?
Motivational Therapy: This line of treatment is used for younger children with primary nocturnal enuresis with the help of rewards or motivation. Because of the younger age group, this treatment has a 75 % chance of success. However, children can also get frustrated with this lengthy treatment.
Bladder Training: During this, the children are asked to train their bladders to use the facility sparingly for longer. Although the improvement chances are slim, this training has no adverse effect.
Dry-Bed Training: During this, young ones are woken up at the specified interval to empty the bladder. There are chances of improvement with the condition in the children, but the main side effect is that their sleep cycle is disturbed, and this causes a whole new set of complications.
Enuresis Alarm: Almost two-thirds of the older children with primary nocturnal enuresis succeeded with this treatment. In this treatment, the children are awakened by the alarm triggered by wetness.
Biofeedback: The pelvic floor muscle relaxation technique is used in older children with dysfunctional voiding problems.
Medicine: A pediatrician prescribes oral medicine according to the age and severity of the condition to help control the bed-wetting.
Fluid Intake: Fluid intake just before bedtime should be avoided.
Conclusion
Involuntary urination is a problem that is easily left untreated and ignored by parents. If the child continues bedwetting after 7 years of age, it needs a doctor's consultation. It sometimes resolves with age, but others need a special diagnosis to know the condition's root cause. If the parents are worried about the older children facing the issue, it is best to visit the doctor to ask for help to cope with the condition. Moreover, if the condition is left untreated, there are many psychological and emotional changes, like shame, stress, and embarrassment, in children.
