Childhood Bedwetting

(Ivanhoe Newswire)-- Many children experience bedwetting in their childhood, but a new study shows various components to the bedwetting that were previously unknown.

Although children usually outgrow bedwetting, it's fairly common among children ages 5 and up. It's more common in boys. An American study found a prevalence of bedwetting of 6.21% in boys compared with 2.51% in girls. There is also a strong genetic aspect to bedwetting, as a large British study found a significantly higher likelihood of bedwetting if a parent was a bedwetter.

Several known conditions usually contribute to bedwetting including: excessive urine production at night, an overactive bladder and an inability to wake up in response to the need to urinate. Although the condition itself is not associated with a major illness, it is important for physicians to conduct a physical exam to rule out any other causes. Urinalysis and urine culture may be the only necessary tests as evidence shows that other investigations are not particularly useful or cost effective.

"The most critical aspect of treatment is reassurance for the child, who may experience low self-esteem," Dr. Darcie Kiddoo, Divisions of Pediatric Surgery and Urology, University of Alberta, Edmonton, Alberta, was quoted as saying. "Parents must understand that, unlike daytime behaviour, nighttime incontinence is not within the child's control."

Bedwetting treatment varies from lifestyle changes to medication and alternative therapies for which there is little evidence that it works. Desmopressin, a medication that works on the kidneys to reabsorb urine, is successful in reducing nighttime water production but the benefits stop when medication is stopped. Tricyclic antidepressants can be effective in some children, but there are adverse effects and few parents choose this option.

Bed alarms have shown the most long-term success. "A systematic review found that after 10?? weeks, 66% of children maintained 14 consecutive dry nights compared with only 4% of children with no treatment," Dr. Kiddoo was quoted as saying. The effect lasts after the device is no longer used, but parental vigilance is required to help children wake up if they do not hear the alarm.

SOURCE: Canadian Medical Association, April 23, 2012