Urologist clarifies

What can help with bedwetting in preschool children

Involuntary bedwetting (enuresis) is a common problem in medical practice, affecting around 15 to 20 percent of preschool children. However, there are good treatment options that are individually tailored to the little patients to help them have more dry nights. 

Various treatment options can correct the imbalance between bladder capacity and the amount of urine produced or reduce the strength of the stimulus to the bladder that wakes the child up at night, as urologist Dr. Romana Altenhuber reports in the specialist magazine "Ärzte Krone". However, the therapy must always be individually tailored to the patient, as the problem and the response to treatment can vary greatly.

Finding the optimal therapy
By taking a detailed medical history, the doctor checks the child's development, general health aspects, the onset of enuresis (has the child never been dry or is it a relapse?), accompanying symptoms during the day and bowel movements (enuresis is often accompanied by chronic constipation).

In addition to urinalysis and ultrasound of the urinary tract, the social environment and any behavioral abnormalities are also considered. It is also helpful if parents document their child's drinking and toileting behavior (micturition log).

A good educational discussion is very important for this topic, which is often considered taboo. "General behavioral measures, such as shifting drinking to the morning or early afternoon, avoiding carbonated drinks and emptying the bladder completely before going to bed, are often enough to avoid wet nights," says the expert.

If this does not lead to the desired success, further therapy can be effective:

• In alarm therapy, the wake-up stimulus is linked to wetting with the help of a sensor. This can suppress the process that leads to emptying the bladder (micturition) or temporarily convert the wetting into a nocturnal urge to urinate (nocturia) until the child can sleep through the night.
• A reduction in nocturnal urine production can be achieved with special medication (desmopressin). There are also effective drugs (anticholinergics) for low functional bladder capacity or symptoms of the lower urinary tract (LUTS).
• The treatment of bladder overactivity in children is usually lengthy and often only successful after weeks. Sometimes it even requires a combination therapy.