Urine - Urination

Urinary incontinence or involuntary loss of urine in children


The reason why the child wet the bed does not seem to have a single reason, there are many factors that can be triggers of the urinary incontinence or involuntary loss of urine in children. The reason why this pathology occurs could not be explained by an exclusive reason. Among the main causes is a decreased secretion of ADH, an anti-diuretic hormone, in children who wet the bed. This hormone is responsible for reducing the amount of urine generated at night. We analyze this and other causes of infantile enuresis.

Between 3 and 5 years it is expected that babies leave diapers at night and begin to control their bladder, getting up 1 or 2 times at night, but this is not always the case. Enuresis is the medical term for 'bed wetting' or involuntary urination, which can occur during the day or at night.

There are two types of enuresis: primary and secondary. People with primary nocturnal enuresis have urinated since they were babies. Secondary enuresis is a condition that develops at least 6 months (or even years) after you have learned to control your bladder.

But we really talk about enuresis when in boys, after 5 years and in girls after 6 years, they still cannot control urination, that is, they still urinate on themselves or in this case on the bed. And in turn it is more common in boys than girls.

Primary enuresis is the most common. When we find secondary enuresis in adolescents or children older than 5 years, it should be evaluated by a doctor, because it could be due to urinary infections

There is currently no common cause of enuresis, but it is believed to occur from delayed development of the bladder, which fills up more at night, the kidney that produces more urine at night, and the brain where there may be a disability to voluntarily wake up to urinate.

We know very well that, in infants and children, the brain and bladder are not in tune, so the bladder releases itself when it feels full, and as they grow, the brain can control the bladder, causing you resist the urge to urinate, but it happens first during the day and then at night. However, there are more factors that can influence as a trigger of the urinary incontinence, among them:

- A bad learning of toilet training
This may be the case of children who are required to control before their time, without being mature enough. A bad acquisition can cause rejection before its implementation. In most children, a primary enuresis occurs, that is, those who have never or almost never controlled their urination.

- Psychological factors of enuresis
You will say, but as a child you can have stress. It turns out that when routines or habits change, they generate stress for the child. Stressful situations such as a change of home, school, the birth of a new sibling, relationship problems between parents or school failure can act as a trigger for secondary enuresis, that is, a lack of control, after a long period of control of urine. Anxiety situations in children are easy prey to start suffering from enuresis.

- Organic causes of enuresis
Only in a minority of cases of childhood enuresis (5 percent), it is concluded that the enuresis triggers are an organic cause. This disorder is usually associated most of the time with other symptoms.

These three causes already mentioned are the most common, but there are other factors that can trigger the involuntary loss of urine by the child:

- Genetics
If either parent has a history of wetting the bed before the age of 5, the child has a 40% chance of doing the same and if they are both parents there is a 70% chance.

- Deep sleep
We know that as children get older, they sleep more at night and tend to have a deeper sleep, where they are unable to wake up to urinate.

- Bladder or kidney diseases
These make it impossible for the child to control the bladder and to empty itself.

- Neurological diseases
It occurs because there is a delay in the brain-bladder connection.

- constipation
The bowel and bladder are very close together, and a full bowel can put pressure on the bladder, causing the bladder to empty itself.

How is urinary incontinence diagnosed in children? In addition to starting to show, the wet bed or wet pants, the doctor should be taken specifically to the pediatric nephrologist, who will evaluate and take a medical history, looking for the cause of this enuresis or urinary incontinence.

Another of the most common questions of parents is if it is something that has treatment. It usually resolves on its own before the age of 6. If the cause is found, and it is a secondary enuresis, there is also a method of alarms. They are alarms that detect moisture in clothing or sheets and sound when they are damp or wet. It is said that 70% of children who use it stop wetting the bed with a resolution in 6 months, although there are many voices that are against it because they say that it damages the child's self-esteem.

There are endorsed medications that are used for infant urinary incontinence and your pediatrician or nephrologist is the one who will assess whether they are needed or not. Another tip that we can give parents from here is to limit the consumption of drinks or foods with salt during the night.

And, encourage your child to go to the bathroom regularly during the day, and if possible help him get up at night, even once to urinate. The most important thing is not to scold or punish the child, since they do not do it because they want to.

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Video: Neurogenic Bladder: Dr. Khoury, CHOC Childrens (September 2020).