Enuresis (Bed Wetting)

Introduction

Enuresis is the medical term for bedwetting during sleep.
It is not considered abnormal until a child is older and wets the bed consistently (at least twice a week for 3 months or more).

Enuresis diagnostic criteria

  • Repeated voiding of urine into bed or clothes (whether involuntary or intentional)
  • Behaviour must be clinically significant as manifested by either a frequency of twice a week for at least three consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.
  • Chronological age is at least 5 years of age (or equivalent developmental level).
  • The behaviour is not due exclusively to the direct physiological effect of a substance (such as a diuretic) or a general medical condition (such as diabetes, spina bifida, a seizure disorder, etc.).

Treatment for enuresis

Non-pharmacological Treatment

  • Fluid restriction at night: If child wakes up during the night, limit the amount that he or she drinks.
  • Star chart effective in one-third of cases
  • Alarm: Child must wake up and urinate.

Pharmacological Treatment

A: amitriptyline (PO) 25mg nocte (medications should be titrated according to symptoms resolution)

OR

C: imipramine (PO) 100mg nocte (medications should be titrated according to symptoms resolution).