Enuresis is also known as bedwetting is the complete emptying of the urinary bladder at the wrong place and wrong time at least two times in a month and after the fifth birthday of the child. Many children achieve full control of diurnal and nocturnal passing of urine when they reach the fifth year of their life. Bedwetting at night is termed as nocturnal enuresis.
Types of enuresis :
- Primary enuresis.
- Secondary enuresis.
Primary enuresis:
Is the repeated passage of urine into clothes or in bed during the night at least two times a week for a minimum of three continuous months in a child whose age is more than or equal to five years. It is common in boys than the girl. The development of primary enuresis has many factors like sleep disorders, decreased secretion of nocturnal ADH, psychological and genetic cause. In very few numbers of children, it is caused due to organic pathologies such as urinary tract infection (UTI) and obstructive uropathy.
Secondary enuresis:
The child starts bedwetting again, after the many dry months, the main cause is over-enthusiastic and immature toilet training, some times both type of diabetes like diabetes mellitus and diabetes insipidus and urinary tract infections, is the cause, there are some psychological cause also which becomes the cause of secondary enuresis, these factors mainly are, maladjustment of child with his or her parents and emotional stress.
Classification of nocturnal enuresis or Bedwetting:
- Monosymptomatic
- Diurnal enuresis without daytime frequency.
- Nocturnal enuresis with daytime frequency.
- Nocturnal enuresis with daytime frequency and voiding dysfunction.
Investigation of nocturnal enuresis or Bedwetting:
- A detailed medical history is very important which will also cover both neurological and genital examination, which will help to rule out any organic cause.
- Urine examination is advisable for culture and routine and microscopic examination.
- Urodynamic studies must be done if bedwetting at night is present with urinary tract infection (UTI).
Very few children have an organic cause for their bedwetting at night.
Treatment :
Treatment without medicinal approach
- Bladder exercises: Ask the child to hold urine as long as possible during the day (but must be told not too long), to pass and stop the urine (parent’s presence is a must), to go to the toilet before going to sleep
- Parents must not scold the child and must try to change his or her wet bedsheet without informing him or her.
- Restrict the liquid after the meal in the evening
- The alarm device is used to elicit a response of awakening when the urinary bladder is full, there is a sensor in alarm device which is attached to the undergarment of the child and it is placed somewhere in the bed.
Treatment with homeopathic medicines:
Treatment with homeopathic medicines give an excellent result in bedwetting problem in children, they are potentized medicines and so have no side effect, they are easy to administer with sugar pills and that’s why they are palatable, their dynamic action helps to strengthen bladder muscles and overcome the problem of bedwetting in children. Homeopathy medicines counter many other problems in children. Homeopathy medicines give prompt relief in the enuresis or bedwetting.