Incontinence at Children

All children can wet the diaper but the problem of night wetting in children over the age of 5 is mostly genetic. But if this happens more than 2 times a week in 3 months, if the child urinates more than 7 times a day, runs to the toilet or goes at the last minute, the child may need treatment. Around 3 percent of children wetting the bed at night are diagnosed with other diseases such as congenital disorders of the kidney and urinary tract, kidney diseases, occult waist bones (spina bifida), diabetes, epilepsy, parasites, food allergies.


 

Experienced physician and staff

Some of the children who wet the bed in the night will recover spontaneously, but treatment is recommended because this may cause problems for the child and the family, reduce the child's self-confidence, and may have other behavioral and affective problems together. Before starting treatment in Liv Hospital Pediatric Surgery and Urology Clinic, a specialist physician who is experienced in night wtting performs a detailed physical examination of the child and reviews all other causes that may lead to urinary incontinence.
 

The family, child and physician should collaborate

The first condition for successful treatment is full co-operation between family, child and physician. The main principle is to reassure the child by eliminating the feeling of guilt and, if possible, to ensure that the child owns up to the incident. The first method to try involve programs that require the child or the family to wake up at night. First attempt is to have the child wake up on his/her own. If this is not possible, a program that involves the family waking up and waking the child at night to go to the toilet. If motivation threapy and drug therapy are applied in combination with the family's support, treatment success rate reaches 70–80% for these children. The most important disadvantage of drug treatment is the high risk of recurrence after discontinuation of treatment. Therefore, the current recommendation is to use alarm devices and drug therapy in combination. Alarm devices are tools that wake up the child as soon as the child starts to urinate, and help the child to control their bladder. Alarm treatment should continue for at least 3 months, and this provides cure for children up to 85%. Recurrence rates after alarm treatment is very low.
 

Caution if it happens more than 2 times a week in 3 months  

Unconscious urination during night's sleep at least two times a week in children over 5 years of age is called night wetting. Healthy children may also lose urine at night if they drink excessive fluids before sleep. However, this incident should repeat for more than 2 times a week for 3 months in order to be considered a medical condition and take the decision to treat it. There are two kinds of night wetting. If it has been present from the beginning, it is called primary night wetting, if it emerged later it is called secondary night wetting.
 

How frequent is it?

Night wetting is often the result of a delay in the development of the bladder. Therefore, the frequency decreases with age and occurs more frequently in boys than in girls. While 40 percent of children under 3 experience night wetting, this rate drops to 20 percent at age 5 and to 10 percent at age 6.  Night wetting is largely based on genetic predisposition. 44 percent of the children with one parent with a history of night wetting, and 77 percent of the children with both parents with a history of night wetting have this problem. The fact that psychological phenomena in general do not lead to the common primary night wetting reveals that the majority of these children do not need to be examined for a mental problem. Around 3 percent of children wetting the bed at night are diagnosed with other diseases such as congenital disorders of the kidney and urinary tract, kidney diseases, occult waist bones (spina bifida), diabetes, epilepsy, parasites, food allergies.
 

How is it treated?

Putting a child who wets the bed in a diaper eliminates the discomfort but never eliminates the night wetting problem. Some of the children who wet the bed in the night will recover spontaneously, but treatment is recommended because this may cause problems for the child and the family, reduce the child's self-confidence, and may have other behavioral and affective problems together. Before treatment, a specialist experienced in night wetting has to perform a detailed physical examination of the child, and all other causes that may lead to incontinence have to be reviewed.
 

The family, child and physician should collaborate

The first condition for successful treatment is full co-operation between family, child and physician. The main principle is to reassure the child by eliminating the feeling of guilt and, if possible, to ensure that the child owns up to the incident. The first method to try involve programs that require the child or the family to wake up at night. First attempt is to have the child wake up on his/her own. If this is not possible, a program that involves the family waking up and waking the child at night to go to the toilet. If motivation threapy and drug therapy are applied in combination with the family's support, treatment success rate reaches 70–80% for these children. The most important disadvantage of drug treatment is the high risk of recurrence after discontinuation of treatment. Therefore, the current recommendation is to use alarm devices and drug therapy in combination. Alarm devices are tools that wake up the child as soon as the child starts to urinate, and help the child to control their bladder. Alarm treatment should continue for at least 3 months, and this provides cure for children up to 85%. Recurrence rates after alarm treatment is very low.
 

Pay attention to symptoms

• If the night wetting started suddenly after a period of no wetting,
• If the child also wets during the day
• If constipation or underwear soiling is present,
• If the child has pain when urinating,
• If the child urinates more than 7 times a day
• If the child runs to the toilet or goes at the last minute,
• If the number of night weting is more than 2 per week and more than 1 per night, 
• If the amount of urination during the night is small, but the number is high