One of the normal stages of a child’s development is the acquisition of sphincter control; this generally happens for females around the age of two, for males at three. In some cases, however, in older children, repeated voluntary or involuntary release of urine may occur. Bedwetting can occur during the day or during the night; in some cases it is both diurnal and nocturnal.
Bedwetting is very often a transient phenomenon, and parents don’t have to worry about pee leaks until the age of five or six, as bladder control is still maturing. For this condition to be classified as a disorder, the chronological age to refer to is at least 5 years and the episodes must be at least twice a week for three consecutive months. Enuresis can be divided into primary, if present from birth, or secondary, if it occurs after the child has already acquired bladder control.
Bedwetting can have different types of causes; from a physiological point of view, it may be due to a delay in the maturation of the bladder or to an excessive production of urine during the night. In other cases, the onset of enuresis is linked to a stressful event or to emotional or behavioral disorders; it could therefore appear following the separation of the parents, the birth of a brother, school stress, a bereavement.
Treatment of enuresis
Before planning the most appropriate intervention plan, it is essential to establish whether the enuresis is physiological or psychological in nature; it is also important to investigate the different aspects of the child’s family and social life and the specific aspects of the problem (onset, frequency, sleep-wake rhythms, etc…).
In order for the psychological treatment to be implemented, some preliminary conditions are necessary, such as the absence of organic origins at the basis of the disorder and of family factors that may justify the maintenance of the discomfort.
Cognitive behavioral therapy applied in close collaboration with the parents is indicated for the treatment of enuresis. During the surgery it is good to keep in mind some simple indications: the child should never be scolded because of the episodes of enuresis; it is instead useful to reassure him, giving the example of other family members or acquaintances who have had the same problem during childhood and explaining that it is a transitory condition.
