Q: What is enuresis?

A: Enuresis is the loss of bladder control that leads to the release of urine. There are no associated urological abnormalities. It usually occurs in children over five years old who have never had night dryness for more than six months. There are several kinds of enuresis. Nocturnal enuresis is called "bedwetting," because it happens during the night while a child is sleeping. Bedwetting is fairly common; approximately 5 million to 7 million children wet the bed in the United States. It may happen more often in boys than in girls.

Q: When do I know that my child needs help?

A: Ask yourself a few simple questions. If you answer yes to any of these questions, it may be time to seek help. We will be happy to discuss your specific situation.

  • Have you, as a family, become frustrated with daily laundry and making excuses for avoiding sleepovers?
  • Has your doctor or nurse practitioner recommended that you try an alarm or other treatment?
  • Is your child over six and does he or she continue to experience day or night wetting?
  • Have you tried other programs without success?

Q: What causes bedwetting?

A: Your child may wet the bed for a number of different reasons. Bedwetting isn't caused by drinking too much liquid before bedtime or because your child is too lazy to go to the bathroom. Often, it's a combination of things rather than just one. Some of the causes of bedwetting include:

  • Slower than normal development of the nervous system-- the sensory output resulting from the stretching of the bladder is not perceived or is not sent to the brain, reducing the child's ability to stop the bladder from emptying.
  • Genetic factors (it tends to run in families) -- Heredity as a causative factor of bedwetting has been confirmed by the identification of a gene marker.
  • Difficulties waking up from sleep - results from sleep studies are mixed, but generally, children who wet have difficulty waking from sleep.
  • Hormonal factors (not enough antidiuretic hormone which reduces the amount of urine made by the kidneys) -- children with enuresis did not show a normal rise in the nocturnal secretion of antidiuretic hormone.
  • Urinary tract infections
  • Food sensitivities
  • Constipation
  • Anatomic factors - A small percent of children may have abnormalities in the spinal cord, or abnormalities in the urethral valves in boys or in the ureter in girls or boys

Q: How can Enuresis Associates help?

A: Our practice specializes in the treatment of bedwetting. We are the Baltimore-Washington's only practice focused on the evaluation and treatment of enuresis.

Q: How is my child's bedwetting treated?

A: First, your nurse practitioner will ask you to complete a history of your child's daytime and nighttime bathroom and dietary habits. Then she will do a physical exam and perhaps a urine test (called a urinalysis) to rule out problems in the urinary tract and bladder. A treatment approach is then developed based upon your child's specific circumstances. No matter what treatment combination is chosen for your child, it's most successful when the parents, the child and your nurse practitioner work together to be supportive for the child.

Q: What happens after the initial consultation?

A: One of the most important components of this program is the ongoing involvement of the child, family and your nurse practitioner. Bedwetting is not something you can quickly "fix and forget". It requires patience and determination. Telephone or office visits are scheduled to create a supportive environment, monitor progress, adjust treatment and assure that the entire family remains committed to helping the child achieve dry nights.

Q: What kinds of medications are used?

A: It depends. Medicines aren't a cure for bedwetting, but they may help some children that are older and that have failed initial behavior therapy. The medicines work in two ways. One kind of medicine helps the bladder hold more urine, and the other kind helps the kidneys make less urine.

Q: Will my insurance cover the costs of treatment?

A: Typically, yes. Your office visits may be reimbursable by your insurance company, (less the applicable deductible or co-pay). You may call your insurance company and ask about your specific plan coverage. We ask that you pay for the visit at the time of service. Enuresis Associates provides you with a Superbill, which provides the necessary provider information, diagnosis and coding information needed for you to submit to seek reimbursement from your insurer.

Q: What do I need to do if I'm interested?

A: Call our office at 410-209-9705 to arrange for an initial appointment. The initial appointment with you and your child lasts an hour. Information that you record at home before the office visit is evaluated and a comprehensive treatment plan is formed. Your child can begin treatment that night.

Q: Where can I buy an alarm?

A: You'll find everything you need at the Bedwetting Store. Click on the link below to go there. The Bedwetting Starter kits include the tools you need to begin treatment at home, if you prefer not having an individualized evaluation.

Bedwetting Store

Copyright © 2000-2013 Enuresis Associates LLC All rights reserved. The information provided on dryatnight.com is for educational purposes only and is not a substitute for specific medical advice and treatment concerning your child's situation. Contact us at 410-209-9705 or 8186 Lark Brown Rd Ste 301, Elkdridge, MD 21075

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