Bedwetting

Bedwetting is considered a natural part of development. Most children will outgrow the problem. Nonetheless, it can be very disturbing and can affect your child's self-esteem or quality of life.

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Symptoms

Routine bedwetting typically occurs only at night with no other symptoms than wet bedclothes and pajamas. Atypical bedwetting may occur as a result of psychological issues or problems with the kidneys, urinary tract or nervous system, and may include:

• incontinence during the day
• burning when urinating
• straining when urinating
• dribbling urine
• urine that appears cloudy or tinted pink
• blood stains in underwear
• fecal incontinence
• constipation

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Risk Factors

Generally, most children do not have an anatomical or physical cause for their bedwetting. Instead, bedwetting occurs when several factors come together - more urine is produced during the night than the bladder size and, at the same time, your child fails to wake up when their bladder is overfilled.

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When to see a doctor

It's a good idea to call your doctor if your child suddenly starts wetting the bed after being consistently dry for at least 6 months. You may also want to call the doctor if your child begins to wet his or her pants during the day, starts misbehaving at school or at home, or if your child complains of a burning sensation when he or she goes to the bathroom.

In rare cases, such as when bedwetting begins abruptly and is accompanied by other symptoms, bedwetting can be a sign of another medical condition, and you may want to talk with your child's doctor. The doctor may check for signs of a urinary tract infection, constipation, bladder problems, diabetes, or severe stress.

In addition to a physical exam, additional tests may be recommended to identify or eliminate other conditions that could be contributing to bedwetting. These tests include: 

• urinalysis to check for signs of infection
• imaging tests to look at the bladder or kidneys
• other tests, depending on the patient's health history and other factors

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Treatment

Once this information is retrieved with the use of basic evaluations, the best treatment can be identified based on the problem. This includes:

• Reducing the amount of overnight urine. This can be done with diet/behavioral changes or medication (or both)
• Increasing the bladder size at night. This can be done with medications.
• Increasing awakening when or before bladder is overfilled. This can be done with behavioral treatments or medications.

Each child/family is different and it is important to take an individualized approach to each child. It is important to obtain the necessary information for evaluation and be compulsive about the treatments.