Bedwetting

What is Bedwetting
It is also known as Nocturnal enuresis, – is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary (PNE) when a child has not yet had a prolonged period of being dry. Secondarynocturnal enuresis (SNE) is when a child or adult begins wetting again after having stayed dry. Bedwetting is the most common childhood urologic complaint and one of the most common pediatric-health issues. Most bedwetting, however, is just a developmental delay—not an emotional problem or physical illness. Only a small percentage (5% to 10%) of bedwetting cases are caused by specific medical situations.

•Secondary bedwetting can be a sign of an underlying medical or emotional problem.
•The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting.
•Having to urinate frequently.
•Straining, dribbling, or other unusual symptoms with urination.
•Wetting during the day.
•Straining, dribbling, or other unusual symptoms with urination.
•Cloudy or pinkish urine, or blood stains on underpants or pajamas.
•Soiling, being unable to control bowel movements (known as fecal incontinence orencopresis).

• The child cannot yet hold urine for the entire night.
• The child does not waken when his or her bladder is full.
• The child produces a large amount of urine during the evening and night hours.
• The child has poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can. Parents are familiar with the “potty dance” characterized by leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine
.
•Common causes of secondary bedwetting include the following:
Urinary tract infection:
The resulting bladder irritation can cause lower abdominal pain or irritation with urination (dysuria), a stronger urge to urinate (urgency), and frequent urination (frequency). Urinary tract infection in children may indicate another problem, such as an anatomical abnormality.
Diabetes:
People with type I diabetes have a high level of sugar (glucose) in the their blood. The body increases urine output as a consequence of excessive blood glucose levels.
Structural or anatomical abnormality: An abnormality in the organs, muscles, or nerves involved in urination can cause incontinence or other urinary problems that could show up as bedwetting.
Neurological problems:
Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.
Emotional problems:
A stressful home life, as in a home where the parents are in conflict, sometimes causes children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting. Children who are being physically or sexually abused sometimes begin bedwetting.
Sleep patterns:
Obstructive sleep apnea (characterized by excessively loud snoring and/or choking while asleep) can be associated with enuresis.
Pinworm infection:
characterized by intense itching of the anal and/or genital area.
Excessive fluid intake:
Bedwetting tends to run in families. Many children who wet the bed have a parent who did, too. Most of these children stop bedwetting on their own at about the same age the parent did.