Causes and management of Nocturnal enuresis in children

Nocturnal enuresis : it is involuntary urination in an unacceptable time and place in children after the age of maturation of the bladder and sphincter control which is about 4 years , nocturnal enuresis is urination at time , and its prognosis is better than urination at day (diurnal enuresis) .

Incidence : it is the most common type of involuntary urination in children , more common in boys than girls

Causes: there are 2 types of nocturnal enuresis , primary and secondary :

Primary nocturnal enuresis : is involuntry urination in a child who had ever controlled urination , the cause is delayed in maturation in the sphincter control mechanism .

Secondary nocturnal enuresis : is inability to control urination in a child who had controlled urination before , the cause here is psychological as the child may have phobia from school or excess fear from parents or any disturbance in relation of the parents with the child .

Management and treatment of a case of Nocturnal enuresis :

For the secondary and primary causes psycho theraby is very important , the child should urinate before going to bed and avoid excess fluids in the night time , also the parents should give the child a present or any  that please the child for every dry night .

For the primary causes the cause here is delay in the maturation in the sphincter control of the child , so medications may be needed here as desmopressin and anticholinergic drugs which play a great role in decrease in the amount of urine and increase the ability to control the act of urination . Another method to use is the " alarm device " which gives a ring when the sensor feels that there is filling in the bladder and awaken the child before wetting himself .