Enuresis Complete A to Z Guide: 7 Simple Hacks To Treat It

Enuresis is a term that you are unlikely to have heard of. In layman’s terms, it refers to urination that is not voluntary. Let us have a look at a more formal definition of enuresis as follows:

Enuresis is involuntary urination especially by children, particularly at night. It is an inability to control urination.

From this definition, it is important to note that two things that stand out:

➔Cases are more common in children: Intuitively it makes sense that cases of enuresis are more common in children. About 20 % of all 5-year old children suffer from enuresis. The cut-off is not arbitrary. Age 5 is when you can reasonably expect a child to be able to control his or her urge to urinate; therefore, not being able to do so can be a cause for concern although not always so – some children just take a little more time to develop. It could be slightly more perplexing if your 10-year old has that problem although again, it is not unheard of. Enuresis in adults does happen, it is not exclusive to children. We shall look at this in a bit.

➔It occurs most often at night: Enuresis does seem to happen most often at night and not during the daytime. However, as we shall see in this article, it can happen during the daytime as well.

Before we dive in deeper, here is a kuick navigational menu to help you easily navigate the article:

Types of Enuresis:

Enuresis can be broadly classified as follows:

1. Nocturnal enuresis:

Sometimes also referred to as sleep enuresis, this is the most common form of enuresis. As the term nocturnal indicates, it refers to involuntary urination at night. In common parlance, it is also known as bed-wetting.

2. Diurnal enuresis:

This refers to involuntary urination during the day time. While not as prevalent as nocturnal enuresis, it does affect a number of people.

3. Mixed enuresis:

Involuntary urination can happen both during nighttime and daytime. In more technical terms, nocturnal enuresis and diurnal enuresis can occur simultaneously. When this happens, it is called mixed enuresis.

Enuresis May Also Be Grouped Into:

1. Primary enuresis:

This is not really a flaw in the urinary system per se. It refers to enuresis in those who have never been trained or inadequately trained to control urination. Therefore, the parents, caretakers, guardians or whosoever it may be are primarily to blame for primary enuresis.

2. Secondary enuresis:

This refers to those children who have been adequately trained to control urination (unlike in the case of primary enuresis) but still lose control of their urination from time to time, particularly in moments of stress.

Enuresis In Adults

While far more common in children, enuresis in adults is not unheard of. For obvious reasons, it is a lot more difficult for adults to talk about this problem and many of those who suffer from involuntary urination do not talk about it even with their loved ones for fear of being sidelined and made an outcast. The National Association for Continence (NATC) estimates that there are 5 million adults worldwide who suffer from enuresis. The actual number could potentially be much higher because as aforesaid adults do not report or speak up about the issue. They rely on stop gap treatments and look for short term measures rather than addressing the cause.

Symptoms Of Enuresis

The symptoms of enuresis include:

1) Repeated Urination Onto The Clothes or The Bed:

if your child constantly urinates onto his or her clothes or on the bed and if you find these to be wet a lot of the time, you should sit up and take notice. In some cases, these symptoms may simply be a result of your child finding it more convenient to urinate onto the clothes or on the bed and therefore proceeding to do so. When this happens often enough, it becomes a problem and could become involuntary urination at that time. Either way you will have to decide on a course of action if your child’s clothes and/or bed are constantly wet.

2) Irritability And/or Anger:

Enuresis makes a child uncomfortable. Maybe he or she is too embarrassed to talk about it. To make things worse, it is also possible that certain classmates or other people know about your child’s enuresis and constantly poke fun. All this will make your child very irritable and angry. Therefore, if you find that your child is often sulking away in a corner, or seems to be getting unreasonably angry or irritated over no apparent reason, then it may be time to dig deeper and get to the bottom of it.

3) Low Self-esteem/self-confidence:

Enuresis can adversely affect the moral of your child to a large extent. If your child seems to have developed low self-esteem and low self-confidence, then it could very well be due to enuresis. Make sure that you talk to him or her to find out if that is the case.

Causes Of Enuresis

1) Improper or Inadequate Toilet Training:

As mentioned earlier, if your child has not received proper toilet training, then enuresis could stem from that. Primary enuresis has been linked to both sleep enuresis and diurnal enuresis.

2) Stress:

As in most cases, stress and emotional factors play a role when it comes to enuresis. This is particularly true in the cases of secondary enuresis as there is empirical evidence and research which strongly link stress to secondary enuresis.

3) Genetics:

Genetics do tend to be a significant cause of enuresis. The National Association for Continence states that studies have shown that someone with both two parents who suffer or once suffered from enuresis have a 77 % chance of suffering from involuntary urination. It further goes on to state that if just one parent and not both suffers or suffered from enuresis, then the chances of enuresis came down to 40 % (which is still a high number!).

4) Functional Bladder Capacity:

In some people, the functional capacity of the bladder is on the lower side. This means that their bladders can hold an amount of urine that is below what would be expected of a bladder with normal functional capacity. This can cause enuresis.

5) Caffeine and Alcohol:

To be clear, caffeine and alcohol are not significant causes of enuresis by any stretch of the imagination, otherwise there would be many more cases of enuresis given the sheer number of people that consume caffeine and/or alcohol. However, both caffeine and alcohol are bladder irritants in that they could lead to overactive bladder muscles.

6) Onset Of Diabetes:

One of the symptoms of diabetes is excessive urination. Therefore, onset of diabetes could cause enuresis by producing much more urine than the bladder can handle.

7) Urinary Tract Infections (UTIs):

An infection of the urinary tract could trigger enuresis.

8) Attention Deficit Hyperactivity Disorder (ADHD):

Enuresis has been found to disproportionately affect kids with attention deficit hyperactivity disorder. Therefore, if your child is suffering from ADHD, he or she is at greater risk for enuresis.

9) Excessive Production Of Urine During Sleep:

Some people produce amounts of urine in their sleep that well exceed what their bladders can normally handle. This condition is called nocturnal polyuria and is one of the causes of enuresis.

10) Side Effects Of Certain Medications:

Certain medications are known to cause enuresis at times. These include but are not limited to antidepressants, insomnia medications and psychiatric medications.

7 Enuresis Treatments And Medications

Typically, when it is suspected that you have enuresis a comprehensive check-up is required including (not an exhaustive list, you may not need all these either):

➔Blood Pressure measurement and comprehensive blood test

➔Urinalysis and urine culture to determine urine content

➔Uroflowmetry to measure the flow rate and time required for urination

➔Non-invasive techniques that measure the amount of urine left in the bladder after voiding

➔Neurological examinations

As for treatments and medications, they are listed as follows:

1. Management:

You could manage enuresis and ensure that you wake up dry. There are plenty of kits readily available on the market to help you with bed-wetting. Special mattress covers, absorbent briefs and skin care products are also available to make life with enuresis easier and more manageable. The flaw with this is it addresses the symptoms rather than the cause; therefore, the problem does not go away.

2. Wake Up At Night To Urinate:

also called lifting, you could wake your child up at night and make him urinate to empty his bladder. If this becomes a habit, it could bring with it other problems though, as it will disrupt your child’s sleep.

3. Enuresis Alarm:

Enuresis alarms are readily available on the market. A sensor which detects moisture is attached to the child’s underpants. When the child starts to urinate, the sound awakens him or her. Again, the effectiveness of this may be debated. Will it help the child wake up in time to urinate or control the urge to urinate in the long run? The results thus far do seem to show a positive effect of enuresis alarm therapy, particularly in children who are well motivated and have strong will power. It takes about 3 months of continuous alarm training for discernible positive results.

4. Fesoterodine (drug):

This is a drug that is used to treat an overactive bladder. It works by slowing down the production of urine.

5. Detrol (drug):

This is another drug that is used to treat an overactive bladder that is producing excessive amounts of urine. It does have its side-effects though, which include constipation, urine retention, headaches and heart palpitations.

6. Oxybutynin(drug):

This is used to relieve urinary difficulties and is primary used for enuresis and frequent urination. Its side-effects have been known to include dizziness, drowsiness and blurred vision.

7. Desmopressin(tablet):

This tablet facilitates reabsorption of water in the kidneys, thus helping with cases of enuresis.

There are other things that could help with sleep enuresis or diurnal enuresis such as avoiding water intake before bedtime or treating underlying causes such as an onset of diabetes or sleep apnea which could be causing enuresis. Surgery is also an option where enuresis is a result of some structural defect. However, surgery is usually not prescribed for enuresis because it is not very effective as a method of treatment. For young girls or women with enuresis, some pelvic exercises are also prescribed as a first line of treatment, but again it is unclear how effective this is. In some cases, it has proven to be minimally beneficial. People also ask about homeopathic remedies and alternative medicine remedies for involuntary urination. It is not possible to recommend them because findings and research on the whole subject are somewhat lacking. It cannot be said with certainty that they do not work – many swear by homeopathy and alternative medicine- but there is not enough substantial evidence to suggest that they do, at least not at this point of time.

The video below further clarifies things

Conclusion

Enuresis is not a condition which should make you feel ashamed. It is just a disorder not unlike a cold or a cough. Of course, it is easier said than done and only those who suffer from enuresis know the extent to which it can wreak havoc in their lives; but all said and done, it is not the worst condition you could have – it certainly is no cancer or aids. That is not to minimize the suffering of those who suffer from sleep enuresis or diurnal enuresis, but it is meant to reassure them that enuresis treatment is available and effective.

As far as children suffering from involuntary urination are concerned, it is imperative that the parents are fully supportive. It may be possible that they suffer from a lack of self-esteem and confidence as it is. It will take utmost care, support and understanding on the part of parents and loved ones to see them through what would undoubtedly be a tough phase for them. Do not shame them or berate them for it, enuresis is not something they can control.

About the Author joseph

What’s up world! Joe here. I am a writer, wordsmith and a health enthusiast at Gainheal.com. I spend most of my time reading about heath, putting everything I learn into action and of course, knitting words together. This is where I find joy. This is where my soul speaks, without any borders. I’ve seen results with everything I learned myself and practiced. My goal now is to help you, the reader, do the same and more, why not! Thanks and welcome aboard!

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