What Is Enuresis?

“Enuresis” is an inability to control the flow of urine, and “nocturnal” means that this happens at night. The usual definition of nocturnal enuresis is bedwetting in children who are over the age of five.

What Causes Bedwetting?

The exact causes are unknown. However, some factors may include:

• Hereditary – Some literature state that children whose parents used to wet the bed are more likely to do so themselves.
• Antidiuretic hormone - Children who wet the bed may have a lower level of a hormone called the antidiuretic hormone, which suppresses the rate of urine production. This means they may make more urine than most people do at night.
• Delayed growth and development - Some children’s nervous systems are not mature enough to be able to sense when the bladder is full.
• Deep sleep – Inability to wake up in the night to pass urine as some children are very deep sleepers.

Can Bedwetting Be Treated?

Yes. With treatment, majority of children with bedwetting can improve significantly and even overcome it.

What Does Treatment Involve?

There are three main types of treatment:

1. Medication (prescribed by the doctor).
2. Enuresis Alarm (prescribed and followed up by KKH occupational therapists upon a doctor’s referral).
3. Motivational Therapy (a star chart and reward system for children from 5 - 7 years old).

The enuresis alarm trains the child to have a better response to a full bladder. When the child starts to wet the bed, a moisture sensor sends a signal which triggers an alarm to sound. The alarm wakes the child, who then knows it is time to get up and go to the toilet. The sound of the alarm also stimulates the child’s pelvic floor muscles to contract, which then controls the flow of urine. Eventually the alarm causes the child to recognise the feeling of needing to urinate, and the child learns to wake up before the alarm sounds.

The reported success in using the alarm rate is 80%.

Occupational Therapy For Children With Primary Nocturnal Enuresis

This clinic is conducted by occupational therapists. It is tailored for children over the age of 5 and teenagers who are still wetting their beds. The use of enuresis alarm or motivational therapy is used to help stop bedwetting.

How Does The Occupational Therapist Help?

Upon referral from the doctor, the occupational therapist (OT) will assess the suitability of the child in using the alarm or motivational therapy.

The OT will then teach the child and family how to use the alarm or set up a motivational therapy program at home.

As compliance and motivation are essential to success, the OT will follow up with the child until he/she has attained dryness. During these follow up sessions, the OT will review and problem solve with the family and child any issues that are impeding the child’s progress.

Consistent follow up is critical in attaining dryness. Children who do not have follow up can be discouraged and have reduced compliance. They are more likely to give up the program halfway and the problem of bedwetting hence persists.

Once the child has attained dryness, he/she will be reviewed by the doctor and then discharged from the clinic.

Clinic Information

If you are concerned that your child is bedwetting, consult a KKH doctor. An appointment to the KKH occupational therapist is made only upon a KKH doctor’s referral. For enquiries please call Tel: 63941587/8.

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