Ninety percent of cases have no emotional origin
Contrary to what many people think, emotional issues are not always directly related to bedwetting. According to estimates by the Brazilian Society of Urology, 15% of children over the age of five suffer from nocturnal enuresis. Only 10% of cases may have emotional reasons; 90% of episodes have an organic or hereditary origin. Two-thirds of parents who have suffered from the problem may have children with the symptoms of nocturnal enuresis, the technical term for the involuntary habit of urinating in bed after the age at which the child should be able to control it. The problem ranges from children who have to wear diapers day and night, to those who can't control their urine and have involuntary leaks in their clothes during the day, to those who urinate in bed constantly.
"All of these situations greatly compromise children's self-esteem and even contribute to them taking on antisocial behavior, avoiding sleeping over at relatives' and friends' houses out of shame," explains pediatric urologist Ubirajara Barroso. Coordinator of the Center for Childhood Urinary Studies (Cedimi), Barroso points out that urinary incontinence is a serious health problem that needs to be treated quickly. "Depending on the cause, in addition to serious psychological changes, the disease is commonly associated with urinary infections, vesico-urethral reflux and even kidney damage," he warns.
A pioneer and national reference in the integrated treatment of urinary disorders in childhood, Cedimi - with numerous papers published in medical journals in Brazil and abroad - provides free care to the population. The average number of patients seen each month is 80. A multidisciplinary team, made up of a pediatric urologist, physiotherapists, nurses, nutritionists and psychologists, has complete urodynamic equipment to accommodate children and their parents, who need to learn how to deal with the situation. "Unfortunately, due to a lack of information, many parents fight and punish their children for urinary leakage that they can't control without specialized treatment. Some parents even punish them physically," says the specialist.
Diagnosis and treatment to combat bedwetting should be started as soon as possible. The intervention can be medication or electrode therapy. The painless stimuli help the child's brain to recognize that the bladder is full. Children usually stop using diapers between the ages of 2 and 3. "It's advisable to remove the diaper during the day. When the child wakes up dry with some frequency, parents should try to remove the diaper at night as well," Barroso teaches, remembering the importance of respecting the individuality of the little ones, since each child has their own pace of development.
After the age of five, parents should be alert if bedwetting is still frequent. The sooner the problem is treated, the less chance there is of the child suffering from low self-esteem, which can interfere with their emotional development, making them shy, withdrawn and lacking confidence in their own abilities.
Some tips:
- Empty your child's bladder before they go to sleep;
- Reduce your fluid intake at night;
- A child's supposed thirst before bed can be avoided if they drink more fluids during the day, in a distributed way.
- Don't compensate for your child's poor diet during the day with a bottle or glass of milk at night, which increases the volume of fluid filtered by the kidneys.
About Ubirajara Barroso:
Head of the Urology Discipline at the Federal University of Bahia (UFBA), Adjunct Professor at the Bahiana School of Medicine and Public Health, he is a full member of the Bahia Academy of Medicine and coordinator of the Center for Childhood Urinary Disorders (Cedimi). An international lecturer, he has published articles on innovations in the treatment of pathologies in the field of pediatric urology in the world's leading scientific journals.
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