Night enuresis is a situation in which the child inadvertently loses urine during sleep, at least twice a week, without identifying problems in the urinary system.
Night enuresis is common in children under 3 years of age because they cannot identify the need to go to the bathroom to urinate or cannot stand. However, when the child pees in bed very often, especially when he or she is older than 3 years old, it is important to take it to the pediatrician for tests to identify the cause of nighttime enuresis.
Night enuresis can be classified as
Regardless of the type of enuresis, it is important to investigate the cause in order to initiate the most appropriate treatment. The main causes of enuresis are:
Night enuresis may be suspected when the child is 4 years old and continues to urinate in bed or when he or she urinates back in bed after spending more than 6 months controlling his or her urine. However, to diagnose enuresis, the child must be evaluated by a pediatrician and certain tests, such as urine examination, bladder ultrasound, and urodynamic examination, should be performed to study the storage, transportation, and emptying of urine.
Treatment of nocturnal enuresis is very important and should be initiated as soon as possible, especially between the ages of 6 and 8, to avoid problems such as social isolation, conflict with parents, situations of bullying and loss of self-esteem, for example. Therefore, some techniques that can help cure enuresis include:
The child should be rewarded on dry nights, which are those in which he is able not to urinate in bed, receiving hugs, kisses or stars, for example.
This training should be done once a week, to train the ability to identify the sensation of a full bladder. To do this, the child should drink at least 3 glasses of water and check the urge to urinate for at least 3 minutes. If you can take it, next week it should take 6 minutes and the following week, 9 minutes. The goal is that you can be without urinating for 45 minutes.
Waking the child at least twice a night to urinate is a good strategy for learning how to contain their urine. It may be helpful to urinate before bed and set an alarm to wake up 3 hours after bedtime. When you wake up, you have to pee immediately. If your child sleeps more than 6 hours, set the alarm clock every 3 hours.
Your pediatrician may recommend the use of medications, such as desmopressin, to reduce urine production at night or taking antidepressants such as imipramine, especially in cases of hyperactivity or attention deficit or anticholinergic, such as oxybutynin, if necessary.
An alarm can be applied to pajamas, which emits a sound when the child urinates in his pajamas, which wakes him up because the sensor detects the presence of pee in his pyjamas.
Motivational therapy should be indicated by the psychologist and one of the techniques is to ask the child to change and wash his or her pajamas and bedding each time he wets the bed, to increase his or her responsibility.
Treatment usually lasts between 1 and 3 months and requires the use of several techniques at the same time, and parental collaboration is very important for the child to learn not to urinate in bed.