Enuresis
 

Overview

My son urinates on himself doctor, is this disease?

Enuresis is a disorder mam occur in children above 5 years child urinate on himself nocturnal or diurnal on purpose or not more than one time per week 

is it rare disorder doctor?

no it is common disorder in children about 10% in children of 5 years 
nocturnal more than diurnal more in boys than girls 

Types

Primary: Child has no period of dryness after toilet training 
Secondary: Child had a period of dryness after toilet training 

Diagnosis 

Exclude organic and physical causes as: diabetes, UTI diseases, worms infection 
Other important causes: delayed nervous system maturation 
Genetic factor, family or social problems, difficulties in toilet training 
Emotional deprivation and deficient caring 
Common comorbidities: 
Conduct disorder, depression and anxiety, autism spectrum disorder, ADHD, physical , emotional and sexual abuse 

Management:

  • reassuring
  • Early medical intervention prevent any psychiatric complications
  • we have to believe this is disorder and we have to support our child ,accept him .. love him unconditionally
  • stop physical or emotional punishment
  • stop blaming and negative comments
  • positive reward system
  • child have to take some responsibility with mother like changing clothes ,washing 
  • take care of any complications appear like low self-esteem , learning disabilities , anxiety or depression  
  • don't feel shame our lovely child, any problem has a solution , support till improvement 

This regimen for 6-8 weeks and it works in about 90% of cases 

Important instructions:

  • Prevent constipation by increasing fibers in food
  • Stop unhealthy habits ,fast food and drinks especially late night 
  • Use the toilet just before sleep set an alarm for mom and child many times during night
  • make a schedule for a child record every day dry or wet