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Child used to bed wetting despite potty training, urine has strong smell. Could this be a potentially bigger issue?

Feb 2013
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Practicing since : 2002
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Our daughter is 9 years old, has been wetting the bed nightly since potty training unless we wake he up to go potty again at midnight (and then, she may still wet the bed) and the urine smells incredibly strong.
She sleeps so deep, we have trouble waking her up - we tried bed wetting alarms but she sleeps through them.
Is there potentially a bigger issue going on here or is it something she'll outgrow?
BTW - she is a very athletic child having begun gymnastics at 4 years old.
Posted Mon, 3 Jun 2013 in Child Health
Answered by Dr. E Venkata Ramana 51 minutes later

Thank you for your query on Healthcare Magic.

Bedwetting during night is known as nocturnal enuresis. And your daughter problem is looking like primary (persistent) type of nocturnal enuresis.

Was your daughter investigated for this problem with any urine, blood, and ultrasound abdomen investigations?

What about the results if investigated?

Children with nocturnal enuresis are difficult to wake up from sleep. And in children with only nocturnal enuresis usually there will be no underlying abnormalities of urinary tract.

But child should be investigated with less invasive and less costly investigations like complete urine examination (including sugar), urine osmolality, urine for culture, and ultrasound abdomen to look for any urine infection, diabetes, and any urinary tract anomalies.

As your child is having bed wetting during nights, the probability of having urine infections and urinary tract anomalies is rare but it is advised to investigate rule out them.

Most of the children with this problem will outgrow as the age increases.

I recommend you to go for the following first line of therapy. For this to be effective child cooperation and consent is required.

1.Rewarding the child for being dry at night is a useful step. You or the child can chart the dry nights, and with each dry night, a small reward can be given. More substantial rewards can be given for increasing success.

2.The child should void before sleeping.

3. Using an alarm clock to wake the child once 2-3 hour after falls asleep.

4. Punishment or humiliation of the child by parents or others should be strongly discouraged.

5. Restrict the intake of oral liquids after 7pm every day.

I advise you to continue bed wetting alarm in addition to the above measures, so the combined effect will be more effective.

Drugs (imipramine and desmopressin) are the second line of therapy and they are given to children if the above measures are unsuccessful.

Hope I have answered your query, if you have any clarification please let me know in your next follow up query along with the details I have asked.

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