Bed Wetting.

Enuresis or bed wetting is the involuntary passage of urine beyond the age of anticipated control that is usually 5-6 years. 15-20% of children 5 years of age wet their beds. Nearly 5% of 10 year olds will wet, and 1% of adolescents and adults continue to wet. It is twice as common in boys as in girls. Bedwetting also seems to run in families. What are the types of wetting problems? Primary enuresis means that the child has been wet from the beginning, whereas secondary enuresis means that the child had been dry earlier and has now started wetting. The latter condition could be due to urinary infection, diseases like diabetes, structural abnormalities in the urinary passages or stressful situations at school or at home like divorce, demanding parents or the arrival of a sibling. What are the symptoms? Commonly, wetting at night is the only symptom, but some children also have frequent urination during the daytime with occasional wetting. It has been seen that children who are constipated are more likely to have enuresis. What investigations are needed? The doctor first takes a detailed history and examines the child to exclude structural abnormalities that may be the cause of bed-wetting. In case a doubt persists after examination, the doctor will order a urine test to exclude urinary infection. An ultrasound scan may be done to evaluate the urinary system for structural abnormalities. Rarely, special tests may be asked for, like intravenous pyelography (IVP) that is a special X-ray test after an injection into the vein, or cystometry in which the pressures inside the urinary bladder are measured.