Every sixth child at the age of five wets the bed at night – among 15-year-olds still about 1.5 percent. “Nocturnal bedwetting is usually a great burden for both the child and the parents,” says Dr. Ingo Franke of the Center for Pediatrics at Bonn University Hospital. Fear and shame often affect the self-confidence of children who, because of nocturnal enuresis, for example, do not want to spend the night at a friend’s house or refuse to go on school trips. But nocturnal urination can also occur in adults.
Bedwetting in children is usually well treatable
If a child does not become dry at night, this is usually not due to a psychological cause such as stress, as is often wrongly assumed, but to a delay in maturation. Enuresis nocturna can usually be successfully treated. First, the child undergoes a comprehensive medical examination to rule out organic causes such as malformations of the urinary tract. Using a uroflowmetry device, the doctor can determine whether bladder emptying is actually a functional disorder, as in nocturnal enuresis, or an organic cause, as in the case of an acute urinary tract infection or a neurogenic bladder emptying disorder. Such a device measures urine flow during bladder emptying and reveals a typical course in certain disorders.
Logging drinking patterns
Experience has shown that behavioral therapy achieves very good healing results for enuresis nocturna. First, parents keep a log of their child’s drinking behavior and urination and wetting over a period of four to six weeks. Up to a quarter of all children become dry after logging their drinking behavior and then becoming aware of their drinking habits.
Ringing pants: rarely useful
The use of bell pants, which make a loud ringing sound when they become wet, is considered rather ineffective. This method has a high failure rate of 75 percent, because children often ignore the ringing sound and continue to wet at night. According to the researchers, this method only makes sense if the bell wakes up the parents so that they consistently go to the toilet with the child every time it rings. Only then can this conditioning bring lasting success. “It is quite decisive how high the suffering pressure of both the affected child and the parents is,” says Franke.
Medication for bedwetting?
Dr. Ingo Franke advises against drug therapy: “A child should not regularly take psychotropic drugs due to a delay in maturation.” In addition, the risk of poisoning is quite high if taken incorrectly, he said. However, in special exceptional cases, such as upcoming school trips, the addition of certain hormone preparations makes sense, he said, because they achieve a short-term effect.
Bedwetting due to breathing disorders?
In Sydney, scientists have found a link between bedwetting and nocturnal breathing disorders. Children with excessively large palatine or pharyngeal tonsils could often be relieved of bedwetting by removing the breathing obstructions. Likewise: bedwetters whose breathing is disturbed because of an excessively narrow palate quickly become dry when wearing an expander to expand the pharynx, as initial study results show. In Germany, there are no research approaches in this field yet. The reason why children with nocturnal breathing problems wet themselves is still unclear. “It is possible that the breathing problems cause the negative pressure in the chest to drop so much that certain hormones are produced more frequently, which additionally excrete fluids from the body,” says pediatric nephrologist Franke. “In particular, children with a very persistent course should be examined in a controlled manner in a sleep laboratory suitable for children.” He believes a study on the connection between breathing disorders and bedwetting would be very useful, because it could help many children with fairly simple methods.
Mental stress caused by bedwetting
Whether it affects children or adults, this unpleasant malfunction of the body leads to a high psychological burden and is generally perceived as extremely embarrassing. Therefore, dealing with the subject is rather uptight and those affected are reluctant to come out.The lack of ability to be in control of one’s body and, as a result, to excrete bodily fluids uncontrollably is a terrifying notion for anyone, because it partially deprives one of autonomy and bodily integrity. As a result, adults feel regressed to the state of a helpless toddler and children feel ashamed because they seem to be at a standstill in their development and unable to grow up.
Bedwetting in adults
Although bedwetting most commonly occurs in children, it can affect adults as well. The cause of nocturnal urination may be incontinence, in addition to the organic causes already mentioned. Incontinence, which is conceptually derived from the Latin “incontinentia” (non-behavior) as inability, is due to the disturbance of a physical process and can therefore affect people at any age. Even in adults, a medical examination to determine the exact causes of bedwetting is advisable in order to treat it successfully.
