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BEDWETTING
IN CHILDREN
| 1. |
Q. |
What
is bedwetting? |
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A. |
It
is uncontrollable wetting while asleep in an otherwise healthy
child beyond early childhood. |
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Most
bedwetters seeking treatment in Singapore are: |
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• |
Five
years or older with the majority between seven to 12 years old. |
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• |
Suffering
from frequent bedwetting of at least twice per week with the
majority being almost every night. |
| 2. |
Q. |
Is bedwetting a problem that needs therapy? |
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A. |
Yes,
especially when the child is already at school going age and
the wetting is frequent. |
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• |
Studies
have shown that constant bedwetting can adversely affect the
psychosocial development of the child causing low self-esteem
and poor social adjustment. |
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It
can also cause resentment and anxiety in parents and other family
members. |
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It
constitutes a source pf embarrassment and deters the sufferer
from healthy outdoor activities like overnight camping and travelling. |
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In
Singapore, it has been found that bedwetters and their parents
sought treatment for the followings reasons: |
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Restricted
activities involving overnight sleep outside home. |
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Parental
fatigue. |
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Disrupted
sleep for the household. |
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Fear
underlying disease. |
| 3. |
Q. |
How common is bedwetting? |
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A. |
Actual
incidence of bedwetting is unknown in Singapore. However, it
is believe to be quite common and there is an increasing number
of cases seeking treatment in recent years. |
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It’s
occurrence in Singapore might be under-reported as it had been
found that many sufferers and parents were too embarrassed to
seek treatment while others thought that there is no effective
treatment; thereby suffering in silence. |
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In
Western Countries, the problem is common with a reported incidence
of 10% among 7-year-old, 5% among 10-year-olds and 1% in the
adult population. |
| 4. |
Q. |
What causes bedwetting? |
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A. |
The
exact cause or causes are unknown. Various factors or causes
that have been implicated include: |
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Hereditary
cause. Bedwetting often runs in a family. |
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Inability
to wake up to void urine. Bedwetters are known to be deep sleepers. |
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A
delay in maturation of bladder control at night. Bedwetting
tends to improve with time and the majority of sufferers will
ultimately become dry but this may take years and a small percentage
of them (1%) will continue bedwetting beyond puberty. |
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• |
Lack
of the production of a naturally occurring body hormone called
Anti-Diuretic Hormone (ADH) during sleep in 20-30% of children
with bedwetting. This hormone is important for reducing urine
production at night. |
| 5. |
Q. |
Is bedwetting due to psychological problems? |
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A. |
Absolutely
Not. |
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• |
Bedwetting
is involuntary and the child is actually helpless and have no
control over wetting. |
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In
fact, punishing or blaming a child for bedwetting may actually
lead to psychological problems in a child. |
| 6. |
Q. |
Is there underlying disease like kidney and bladder problems
in bedwetting? |
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A. |
No. The vast majority of bedwetters are healthy with no underlying
disease. |
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Only
rarely is bedwetting associated with other diseases. When this
occurs, it is almost always associated with symptoms like wetting
in the day, pain on passing urine, fever, excessive thirst,
large urine volume or failure to grow. |
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When
bedwetting occurs in a child who has been dry for months, this
may be due to an underlying urine infection or sometimes due
to stressful conditions like a change of environment, change
of school, etc. |
| 7. |
Q. |
Can bedwetting be treated? |
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A. |
Yes. With treatment, the majority of sufferers can become dry
or improve significantly. |
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Although
bedwetting can resolve spontaneously, if left alone, this may
take several years. To date, there are two established treatment
strategies that have claimed about 70-80% success rate: bedwetting
alarm and a synthetic anti-diuretic hormone (ADH) that can concentrate
and reduce urine production. |
| 8. |
Q. |
How does bedwetting alarm help? |
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Bedwetting alarm is a form of conditioning therapy. It comprises
a urine sensitive pad formed by a series of flexible wires connected
to an alarm unit. The detector pad is placed on the child’s
underwear when he goes to sleep. The moment a few drops of urine
comes into contact with the pad, the alarm will be triggered,
awaking the child who will then cease voiding, get out of bed
and complete voiding in the toilet. Several nights of being
awakened in this manner, results in the development of a conditioned
response enabling the child to hold his urine even when this
bladder is full. |
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Thus,
it takes time to train the bladder. Results are often seen only
after weeks of therapy. |
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This
method is effective in 70%-80% of bedwetters but it requires
high motivation and patience on the part of the bedwetters and
their parents, as well as constant support from therapists. |
| 9. |
Q. |
Where can I get help? |
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A |
You can seek advice and treatment from your family doctors. |
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You
may also obtain advice and support from the Society of Continence
(Singapore) or call its hotline telephone number at 6787 0337
for assistance. |
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