BEDWETTING ( Enuresis )

Bedwetting, also known as involuntary urine leakage, is a condition. It particularly manifests during nighttime sleep as the wetting of the sheets due to the inability to control urination while the person is asleep. Although bedwetting is a common problem in childhood, in some cases it may continue into adolescence or adulthood. In children over 5 years of age, in the absence of any physiological problem, nighttime bedwetting occurring at least twice a week for at least three months is called nocturnal enuresis. In secondary nocturnal enuresis, the likelihood of emotional and behavioral problems and stressful life events is higher. It is seen three times more frequently in males than in females. It tends to decrease during adolescence, with a reported prevalence of 1-2%. Genetic factors play a role in its occurrence. If one of the parents has it, the probability of occurrence in the child is 40%, whereas if both parents have it, the probability of occurrence in the child is 70%. NE most frequently occurs in the first third of the night. These children’s sleep is deep, and parents usually have difficulty waking them up.

In NE, there is a comorbid psychiatric diagnosis at a rate of 20-40%. The most common psychiatric conditions are ADHD, oppositional defiant disorder, depression, and anxiety disorder. Other accompanying psychiatric conditions should be addressed from a treatment perspective. If constipation and encopresis are present, these should be treated first. Punitive, condemning, embarrassing, and frightening attitudes should be discontinued.

Appropriate toilet training and fluid intake, going to the toilet before bedtime, restricting fluid intake before bedtime, teaching bladder exercises, recording wet and dry nights with the calendar method, and applying a reward system for days without wetting are useful behavioral methods. If behavioral methods are insufficient, especially the alarm method can be an effective and useful method that can be used under the supervision of a child and adolescent psychiatry specialist. The efficacy of medication treatments is weak, and there is a high probability of recurrence after discontinuation of medication treatment.