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
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
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
Urinary tract infections
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 one of Baltimore-Washington's only practices 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
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.