Hello XXXXXXX

Thanks for the query. I am happy to help you with your question.

With bed wetting, the first question is, has your son already been dry at night and now he has reverted to bed wetting or has he never been dry? Is he taking any medications?
Does he have any other medical conditions?
Has his growth and development been otherwise normal?
Are there any stresses in the household?
Is he a heavy sleeper?
What have you tried so far?
Had he tried nothing to drink after dinner and a trip to the toilet immediately before bed?

Please let me know the answer to these questions. I will follow up with you promptly after receiving them.

Best regards,
Dr. Schwartz

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Hello again XXXXXXX

When a child has never been dry overnight, it is called Primary Nocturnal Enuresis. For the purposes of this discussion I am assuming that he is toilet trained during the day, and he has no other bladder problems such as voiding less than three times per day for more than eight times per day; a weak stream; other difficulty voiding; for pain in the genitals.

This condition is common in children. At age 7, approximately 10% of children have nighttime bedwetting. Boys are affected about twice as often as girls.

There are a variety of reasons why a child does not yet have nighttime bladder control. Your doctor will be able to rule out important or treatable causes. In order to do this, he or she will take a complete medical history, family history, social history and perform a complete physical examination. They may also order certain tasks such as sugar, thyroid and urinalysis.

In general, the ability to maintain dryness overnight is dependent on maturation of the bladder, which is a complex interaction among various muscles and nerves. So most cases of primary nocturnal enuresis occur in perfectly normal healthy children with no underlying medical conditions other than a not yet fully mature bladder.

Statistically, almost all children eventually develop overnight bladder control. This can be seen in the statistic that only 2 to 3% of 12-year-olds do not have overnight bladder control. Until this age is reached, the approaches include withholding fluids after the evening meal and voiding immediately before bedtime. A nondrug approach to help train the bladder he is a bedwetting alarm, which detects moisture and wakes the child up. This is a form of behavior modification. A pharmacologic approach is a medicine called DDAVP, also known as desmopressin or anti-diuretic hormone. This is easily taken as a nasal spray. It's effect is to allow the kidneys to reabsorb more water and thereby produce less urine overnight. Your doctor will be able to help you decide whether this is right for your son.

I hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please do not forget to accept it.

Best regards,
Dr. Schwartz

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