Ask an Expert: Enuresis

Urinary and Genital Disorders (Children)

Enuresis
09/10/1998

Question:

My son is 11.5 years of age and persists in bedwetting. For years he was wetting on a nightly basis, even if awakened in the middle of the night to urinate. Although he now wets slightly less frequently, but still often enough to require plastic bedding, etc. He was evaluated by a pediatrician who specializes in the problem about a year ago, and we were assured that the problem would go away soon. He is an otherwise well-adjusted child. We have tried not to make an issue of the problem so as not to add any undue psychological overlay, but from time to time, he expresses concern about whether his problem is going to come to an end. Of course, it also creates some difficulty when other children wish to sleep over or vice versa. Do you have any suggestions for dealing with this problem? Thank You.

Answer:

This is one of the most commonly asked questions. It is commonly asked because so many children are affected by this. Fifteen percent of all 5 year old children wet the bed and that number drops off to 1% of all 15 year olds. Bedwetting often runs in families. Children with bedwetting are typically very deep sleepers. We don't really understand what causes the problem but since so many children are affected (as I was when I was young) it may even be considered a normal phase in growing up. In essence there are only three things that can be done. Firstly, one can simply wait for the problem to correct itself. There is a 15% chance that this will happen over a one year period. Second, one can try some medication. There are two types availaible. One is an antidepressant which in low doses can affect bladder function. The other is a hormone that limits the amount of urine a child makes at night. Neither of these cures the problem; rather, they "cover up" the problem while the child outgrows the wetting. The third option is the use of a wetting alarm. These are portable devices which sound off once a child wets. Though these systems offer the greatest potential for cure, a significant number of children will not wake up with the alarm whereas everyone else in the house might. Unfortunately, there is no magic bullet to treat bed wetting. Therapy has to be individualized to the needs and age of the patient.

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Response by:

Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University