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Ask Our Expert: Joseph Raffel, M.D.

Q: My 5-year old wets the bed at least once a week. Should I be concerned?

A: Occasional urinary incontinence is a normal part of growing up, and children who experience nighttime wetting tend to be both physically and emotionally normal. At this time, it is believed nighttime wetting may be caused by several factors, including slower physical development, an over production of urine at night, a lack of ability to recognize bladder filling while asleep, and, in some cases, anxiety. Some children have a family history of bedwetting. In very few cases is incontinence caused by a physical problem in the urinary system.

Fortunately, most urinary incontinence resolves itself with time. You may be interested to know that 10 percent of all 5-year-olds still wet the bed. By age 10, that figure drops to five percent. And at age 18, one percent of the population is still wet at night.

One treatment option is bladder training, which consists of exercises to strengthen and coordinate muscles of the bladder and urethra to help control urination. These techniques also teach the child to anticipate and recognize the need to urinate. I also recommend Kegel exercises to increase muscle control of the sphincter. Delaying urination, having the child wait longer between toileting, may help stretch the bladder so it can retain more fluid. Of course, decrease fluids at dinnertime, and eliminate them completely in the evening.

Battery-driven moisture alarms are available to help awaken the child as the bedwetting begins. For this approach to be effective, however, the child needs to wake up right away. Some children sleep very soundly, so a parent may need to sleep in the same room to help awaken the child as soon as the alarm sounds.

The antidiuretic medication DDAVP may be used to treat the symptoms caused by over-excessive urinary output. For nighttime bedwetting caused by an overactive bladder, Ditropan or Detrol may help calm the bladder muscle and cause it to contract with less force.

If you have further questions or concerns, I recommend you consult with your pediatrician.

Good luck!


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