Wetting in children

Children develop at different rates. This involves not only walking and talking but also becoming dry. Bladder control is a maturation and learning process that needs time and lasts up to about the age of
5 years.

Day- and night-time wetting in children - diagnosis

Differential diagnosis of bedwetting (nocturnal enuresis) and daytime wetting is the basis of successful treatment. The doctor begins by asking questions about bladder voiding habits. In addition, several tests are done, which are neither painful nor uncomfortable for these young patients. Any doctor can perform these basic diagnostic tests.

When asking about drinking and bladder voiding habits, every detail is important:

  • When does the child wet himself/herself and how often?
  • Does the child go to the toilet often during the day or rather seldom and then often too late?
  • Does the urge to urinate occur often and is it impossible to suppress?
  • Is the flow of urine interrupted or spluttering?
  • How large are the volumes of urine passed at one time?
  • Does or did anyone in the family have a similar problem?

The doctor can record the symptoms using a questionnaire.

After a physical examination and urinalysis, an ultrasound scan of the urinary tract and measurement of the post-void residual urine may be performed.

In every case, the doctor needs a drinking and urination record (bladder diary) for the patient. This is kept for 3 days and documents all circumstances associated with drinking or urination.

From these tests, the doctor can in most cases identify whether it is a case of “pure” bedwetting, whether there are also daytime symptoms, or whether wetting happens only during the day.

Further investigations beyond these basic diagnostic tests are only very rarely necessary. These can be required if the basic diagnostic tests yield evidence of possible complicating factors or if all treatment measures based on the basic diagnostic tests are unsuccessful. These investigations are performed by a urologist or in specialist centres. Further investigations include measurement of urine flow, assessment of the bladder filling process, further laboratory tests and possibly additional tests with other specialists.

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