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Bed Wetting
Medical Questions » Bed Wetting
| Name: Bed Wetting |
| Also known as: Enuresis |
| Embarrassing problem that affects up to one in ten five year old and one in 200 adults. |
Causes of Bed Wetting
Urine is retained in the bladder by the contraction of a ring-shaped bundle of muscle (sphincter) that surrounds the bladder opening. To pass urine the sphincter relaxes, and muscles in the wall of the bladder and around the abdominal cavity, contract to squirt the urine out in a steady stream. Bed-wetters tend to sleep very deeply, and during the deepest phases of this sleep, when all the main muscles of the body are totally relaxed, the sphincter also relaxes. Because there is no associated contraction of the muscles in the bladder wall or elsewhere, the urine just dribbles out slowly, not in a hard stream. |
Symptoms of Bed Wetting
Unwanted passing of urine while asleep. |
Tests for Bed Wetting
Exclude any cause by urine tests and kidney ultrasound or X-rays. |
Treatment for Bed Wetting
Several steps in treatment regime, but do not start before five years of age:
1. restrict fluids for three hours before bedtime, take child to the toilet during the night, and establish a reward system for dry nights.
2. bed-wetting alarm that consists of a moisture-sensitive pad that is placed under the patient, a battery and an alarm. When it becomes wet from the first small dribble of urine, it sounds the alarm, the patient is woken, and can empty the bladder before returning to sleep. After a few weeks use, most people learn to waken before the alarm.
3. amitriptyline (Tryptanol) every night to alter the type of sleep. Over a few weeks, the dosage is slowly lowered and hopefully, the bad sleep habits and bed-wetting do not return.
4. desmopressin nasal spray at bed time acts on the pituitary gland in the brain, and this instructs the kidney to reduce the amount of urine produced during the night.
5. psychotherapy in the most resistant cases.
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Complications of Bed Wetting of its treatment
Premature treatment can cause permanent sleep disturbances in a child. No serious long term consequences. |
Likely Outcome of Bed Wetting
In most cases, controlled by cooperation between doctor, patient and family. |
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