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World Bedwetting Day 2017 – Time to take action
Professor Guy Bogaert and Prof. Konstantinos Kamperis
Professor Guy Bogaert, University of Leuven, and Professor Konstantinos Kamperis, Aarhus University Hospital, talked about bedwetting in children at the 28th ESPU Congress, Barcelona April 2017.
Topics of their discussion:
Bedwetting: definition, prevalence, diagnosis, risk factors, prevention, and treatment
Recent studies: the influence of snoring and breastfeeding
Awareness: bedwetting as common condition, effective treatment will improve quality of life
- Is there any good definition of bedwetting?
- Why does it happen with some children, while not with other children?
- We have read some articles about children snoring and children having their tonsils removed, stopped bedwetting. What do you think about that?
- So should we ask the parents about snoring when they come for bedwetting?
- Is it someone´s fault? Did the child or parents something wrong?
- Do you have any idea of how long it takes for parents to come to you because of bedwetting? From what age should they come and actually see a doctor?
- How common is it?
- What would you say to the family, that first comes to you, what should they do. What is the first step?
- What treatment options are there?
- If parents come with their children and the father says for example: I have wet the bed until I was ten. Does it mean anything, is there a hereditary factor for bedwetting at such, and is there also a predicted factor that the child will also wet the bed until ten when they do nothing?
- When parents ask you: Can we do something to prevent that my child not wet the bed so long as I did?
- The longer you are breast feeding the earlier your child would stop with bedwetting, what do you think about that?
- Very often we have families where the parents are certain that there is a psychological reason, what do you think about that?
- Why should parents seek help? Are there any consequences for the children?
Bedwetting in childhood: epidemiology, pathophysiology, and treatment
Enuresis, as defined by the International Children's Continence Society, is the occurrence of urinary incontinence during sleep. Bedwetting (i.e. occurs at least twice a week) is a common childhood condition affecting approximately 5–10% of children aged between 5 and 7 years. The prevalence of bedwetting decreases with age, but approximately 1% of bedwetters continue to do so in adulthood. Bedwetting is twice as common in boys as in girls; for example in the UK, the prevalence of bedwetting at least 3 times a week ranges from 5–10% in 9-year-old girls to 15–22% in 7-year-old boys.
The pathophysiology of enuresis is complex and involves the central nervous system (several neurotransmitters and receptors), circadian rhythm (sleep and diuresis), and bladder dysfunction. Most often, enuresis results from a high arousal threshold (i.e. the child does not awaken to void when the bladder is full) combined with either nocturnal polyuria (i.e. over-production of urine at night) or nocturnal detrusor overactivity (and, therefore, reduced bladder capacity), or both...