Typically, children are able to achieve bladder control by age five. Nocturnal enuresis (bedwetting) occurs in about 20% of healthy five-year-olds and remains a difficulty in as many as 2% of normal children at age 15. Reasons for childhood bedwetting may include any combination of these general factors:
- Genetic factors
- A family history of enuresis
- Hormone irregularity
- Delayed maturation
- A stressful life event, such as the birth of a sibling, the first week of school or a parent’s going away
- Delayed arousal from sleep
- Small functional bladder capacity
- Chronic constipation that can irritate the bladder, resulting in frequent urination.
- Sleep apnea (periods of non-breathing during sleep), which decreases oxygen levels, thus making the child less aware of the sensation of a full bladder.
- Urinary tract infection
- High urine production during the night
The Usual Course of Treatment
For many children, bedwetting will resolve itself over time. As they get older, each year about 15 percent of bedwetters achieve bladder control without treatment.
Behavioral therapy is the most common approach to addressing night-time bedwetting. Preparation of the child, including explanations that he/she can understand, and helping to motivate the child, are essential to the success of behavioral therapy.
Medical intervention may sometimes be warranted. Several classes of drugs have been found useful, including such drugs as desmopressin acetate (DDAVP) to cause the body to produce less urine, the trycyclic antidepressant Imipramine (Tofranil), and anti-spasmodic drugs such as oxybutynin chloride (Ditropan) to reduce the frequency of bladder contractions. Drug treatment is not always successful, and DDAVP may produce mild side effects, including headaches. The anti-spasmodic drugs and, especially, the tricyclics typically produce a greater variety and intensity of side effects.
Alarm therapy and bladder stretching exercises sometimes may be combined with medications.
Acupuncture – a Safe Alternative to Treatment for Childhood Bedwetting
In an NIH study, 15 children with nocturnal enuresis, aged 6–18 years, received four weekly acupuncture treatments. A cure was accomplished in this short period in 20% of the children, with an additional 20% reducing their bedwetting events by half. Two months after treatments ended, 47% were considered cured. A larger study of 50 children found an 86% cure rate at their 6-month follow-up.
In interviews, many acupuncturists have reported cures in three out of four children after ten to twelve visits. Moreover, the relapse rate is found to be lower than the relapse rate of conventional methods of healing bedwetting in children.