Doctors: Children’s nocturnal enuresis must not be underestimated

Bedwetting in babies is a medical problem, not a psychological one. Its cause may be, for example, a serious developmental defect, so it must not be underestimated and delayed visiting a doctor – urologists said on Thursday in Warsaw.

As urologist Dr. Karina Felberg from the Children’s Memorial Health Institute in Warsaw recalled at the press conference, the popular term bedwetting is defined as involuntary urination at night by a child who has already mastered the so-called cleanliness training and is 5 years old.

This is not only a medical problem, but also a social one – around 50 million children worldwide get wet at night. According to Dr. Felberg, involuntary urination affects up to 16 percent. children at the age of 6, 11 percent 7-year-olds, 2-3 percent teenagers and 1 percent. adults. This phenomenon is often self-limiting, but the percentage of people wetting the most intensively, i.e. every night, does not change in individual age groups until adulthood.

According to Dr. Michał Maternik, a pediatric nephrologist from the Medical University of Gdańsk, many parents downplay the problem of bedwetting of their child and delay going to the doctor until the child reaches adolescence. They are often people who wet themselves at night and believe that if the problem resolved on their own, the child will also disappear – said the specialist.

Meanwhile, bedwetting can be caused by a serious malformation of the genitourinary system that requires surgical intervention, emphasized the national consultant in pediatric urology, Prof. Małgorzata Baka-Ostrowska, head of the Children’s Urology Clinic at the Children’s Health Center.

In babies who get wet every night, an important cause of this disorder may be too low production of a hormone called vasopressin, which stops urine production during the night. In these children it is possible to use its synthetic counterpart – desmopressin. This therapy gives a permanent cure in 20-30% of patients. patients, and wetting disappearance or a marked improvement in 70%. In Poland, however, this drug is not reimbursed, so due to a difficult financial situation, parents often do not choose this method.

Constipation can also be one of the causes of enuresis.

According to prof. Baki-Ostrowska, if the doctor does not find any deviations in the physical examination, incl. genitourinary organs, the child’s perineum, and the ultrasound examination of the urinary system is normal, as well as the general urine examination and culture, bedwetting treatment may be performed by the general practitioner. In other situations, the child should be under the care of a specialist. Untreated bedwetting may ultimately lead to kidney dysfunction – to kidney failure and the need for dialysis.

As noted by the pedagogue and psychologist Dorota Zawadzka, it is a myth that enuresis is caused by the emotional state of a child, related e.g. to his family situation. The latest research shows that it plays a role only in 5 percent. cases.

It is known, however, that untreated enuresis can lead to serious mental and emotional problems. These children grow up convinced that they are different, worse, because they are ashamed of their ailments, do not go to camps, camps, or spend the night with their peers. It is especially difficult for schoolchildren – explained the psychologist.

In addition, parents are often ashamed that their children have such ailments and instead of seeking help from a doctor, they try to cope on their own using home remedies or go to a psychologist or psychiatrist first, and then to a specialist – urologist, nephrologist. This time is wasted time and may hinder the success of the therapy – she noted. In her opinion, if a wetting child is not properly treated until his or her adolescence, the problem could leave a mark on the child’s psyche for life.

Joanna Morga (PAP)

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