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BED-WETTING
This refers to involuntary discharge of urine, by an individual who is old enough to control his bladder.
Most of the time they occur at night[Nocturnal] but it may also occur during the day.The bladder is expected to be well developed by the fourth year of life such that a child at 4yrs and beyond should be able to control their bladder.
However findings have shown the occurrence of enuresis as follows:
- 15-20% in children aroound the 5th year
- 5% in children 6-10yr
- 2% in children 11-14yr
There are four known stages in bladder control establishment these are:
ü Awereness of full bladder:seen between 1-2yr
ü Ability to retain urine : seen at 3yrs
ü Ability to stop the flow of urine midstream: seen at 4-5yrs
ü Ability to initiate urination personally: observed at over 5yrs
Basically there are to types of enuresis as bed-wetting is termed medically these are:
Primary Enuresis : in which case the individual has not been able to achieve bladder control since birth.
Secondary Enuresis: here the individual could control the bladder earlier but suddenly lost the control and started bed-wetting.
CAUSES OF BED-WETTING
v Deep sleep or faulty training
v Psychogenic reasons i.e stress
v Urinary tract infection: infections of the urine passage and the bladder may cause enuresis
v Diabetes mellitus
v Urologic disorders;abnormalities in the urine passage,either acquired or inborn.
v Neurologic disorders
v Small functional bladder:a small bladder that gets filled to capacity easily.
TREATMENT
Most cases can be managed with simple methods at home.treatment modalities may be any of the following:
v Waking child up at appropriate hours
v Early evening meals to allow for adequate urination before bedtime.
v Bladder expansion exercise
v Stream interruption exercise
v Alarm bell training
v Tricyclic antidepressants |
