Enuresis

A recurring inability to control urination is referred to as enuresis. The phrase is typically only used to refer to people who are old enough to be expected to exert such control. Urinary incontinence is another name for involuntary urinating.

Types of enuresis:

• Nocturnal enuresis (bedwetting)
• Diurnal enuresis
• Mixed enuresis - Includes a combination of nocturnal and diurnal type. Therefore, urine is passed during both waking and sleeping hours.

Causes

• Anxiety
• Genetics obstructive sleep apnea
• Slow physical development
• Excessive output of urine during sleep
• Structural problem
• Infrequent voiding
• Small bladder capacity
• Constipation

Diagnosis

Enuresis is defined clinically as urinary incontinence occurring after the ages of 4 years for daytime incontinence and 6 years for nighttime incontinence, or loss of continence occurring after 3 months of dryness. Current DSM-IV-TR Criteria:

• Urine leaks repeatedly into beds or clothing (whether involuntary or intentional)
• A behavior must be clinically significant if it occurs twice a week for at least three months in a row or if there is clinically substantial distress or impairment in social, academic (occupational), or other key areas of functioning.
• Age is at least five years old chronologically (or equivalent developmental level).
• The behavior isn't solely brought on by a drug's direct physiological effects (like a diuretic) or a general medical condition.

Treatment

• Moisture alarms:
  • Moisture alarms, sometimes known as bedwetting alarms, can be used at night to wake a person up when they start to urinate. These gadgets consist of an alarm that sounds when moisture is first detected, a wire connecting to a battery-operated control, and a water-sensitive sensor that is clipped on the pajamas. The child must be awakened immediately after the alarm sounds for it to be effective. In order to wake up the bedwetter, it might be necessary to have someone else sleep in the same room.
• Medications:
  • ADH levels can be raised to treat nighttime incontinence. Desmopressin, often known as DDAVP, is a synthetic version of the hormone that can be used to increase levels. Additionally, patients have the option of inhaling a desmopressin-containing mist. Children are permitted to use desmopressin. When a drug is removed, it can be difficult to keep the bed dry, and relapse rates might reach 80%.
• Dry-bed training:
  • Parents can learn how to strengthen bladder control during a visit to the doctor's office by instructing their children to drink increasing amounts of fluids throughout the day and postpone urination for longer periods of time. In addition to positively reinforcing dry nights, they are encouraged to enforce hourly awakenings for bathroom breaks during the night and to establish a cleanup routine for the child (possibly including cleaning more than just the sheets).
• Bladder training:
  • Daytime incontinence may be alleviated using the following methods:
    • Having regular bathroom breaks, such as every two hours (this is called timed voiding).
    • Avoiding things like caffeine and other things that could make a kid incontinent.
    • Adopting tips for good urinating, such as slowing down and relaxing your muscles.