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

  1. Primary
  2. 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 -

  1. Neurological maturation
  2. Mental retardation
  3. Spinal cord maturation defect

Secondary Causes

In this case the child who had been dry for several months starts bed wetting again.

Other Causes

  1. Defective toilet training
  2. Emotional stress
  3. Parent child maladjustment
  4. UTI
  5. J. Diabetes mellitus
  6. Diabetes inspidis

Investigation

  1. Complete urine examination : MIE, Albumin, Sugar, Specific gravity
  2. Ultrasonography

Treatment

Treatment goal is to stop enuresis.

  1. 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

  1. Tricyclic antidepressants like imipramine e.g. Tab Depsonil 25mg to 50mg at bed time.
  2. 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.


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