Urinary problems in women: Nocturnal Enuresis

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Dr Sarita Naik

Dr Sarita Naik (Narang) is a superspecialist urogynaceologist & vaginal surgeon in Mumbai. She earned her MBBS with a gold medal in 2003 from Maulana Azad Medical College,
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My 13-year-old daughter passes urine in bed while sleeping. She has no issues in holding urine in day time. This has been happening since she was a child. Now it is becoming a problem as she doesn’t want to go for trips, overnight camps and tours with her school. Even staying at a relatives’ place generate so much anxiety in her. As a mother I am really concerned. please suggest something.

-Patient

Answer: Appropriate bladder training since childhood goes a long way for a healthy urinary bladder functioning in adult life. Many times, young children avoid going to washroom while they play for long hours. Often, they do not go urination in schools just to avoid public toilets. These habits start reflecting towards bladder control issues as they grow older. Especially in a female child where urinary opening (urethra), vaginal opening (outlet for periods), and fecal passage (rectal opening) are in close proximity to each other.

It is a good habit to train children from early years to go to washroom every 3-4 hours to keep their bladder empty. Keeping regular water intake along with taking regular toilet breaks in school hours help to maintain bladder functioning properly and minimize risks of urinary tract infections.

Specifically, night time bed wetting (Nocturnal Enuresis) can be helped by taking some simple steps. For example:

1) Stop liquid intake at-least 2 hours before bed time. Taking water or milk before sleep makes more urine in night and can cause such episodes.

2) No fizzy drinks, beverages, colas, tea, coffee in evening hours. Caffeinated drinks make more urine, hence leading to overfilling of bladder.

3) Timed voiding – Putting an alarm of around 4 hours after bed time to get up and pass urine is one of the most effective ways to train the bladder and prevent bed wetting.

4) Only after a specialist doctor’s (Urogynaecologist) evaluation, some medications for initial few months can be added to be taken at bed time to help the patient. In severe cases, screening for early onset diabetes and urine infections become necessary.

5) Treatment of coexistent vaginal fungal infections and deworming is often needed in young girls.

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Disclaimer

Views expressed above are the author’s own.



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