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Bed-wetting (Nocturnal Enuresis) – A problem for children and parents.

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Although it is very common in childhood, it should be examined further after 5 years if the bed is wet for a long time. Bed-wetting is more common in boys ages 4-11 than girls. Most parents think that bed-wetting is due to laziness, which is not the root cause.


The cause can be physical or psychosocial factors. When the child is under a lot of pressure all day, be it from parents or from school. The main reasons are:

  1. Stressful family life and conflicts between parents
  2. Bad toilet habits during the day
  3. Urinary tract infection
  4. diabetes
  5. Down syndrome
  6. Attention Deficit Hyperactivity Disorder
  7. Deep sleep and arousal disorder
  8. Congenital malformations of the genitourinary tract
  9. Chronic constipation, where a full bowel puts pressure on the bladder
  10. Slow development of bladder control

Laboratory tests:

  • The urinalysis is the first step where we check pus cells, protein, casts, and glucose to rule out urinary tract infections and kidney disease.
  • Random blood sugar levels are checked to rule out diabetes.
  • The urine culture is based on the urinalysis report.
  • Children with complicated enuresis may need further evaluation with kidney ultrasound and micturition cystourethrograms.


  • Reassurance is the best approach for both the child and the parent.
  • Avoid punitive measures that could affect the child’s psychological development.
  • Fluid intake should be limited to 60 ml after 6-7 p.m.
  • Parents should be sure that the child has a urination before bed.
  • Avoiding sugar and caffeine after 4 p.m. can also be helpful.
  • Waking children up a few hours after falling asleep can help them wake up dry.
  • The child should not be held responsible for bed-wetting.
  • Praise the child and give them a star when they wake up dry.
  • Some pharmacological measures are intended to provide short-term relief, but can only be recommended by doctors if the above measures do not work.
  • If there is an underlying cause such as diabetes or structural abnormalities, treatment will be given first.


Dry. Alekhja.

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