Bedwetting, also called nocturnal enuresis, is a common condition where a child urinates involuntarily during sleep, typically after the age of five. While often dismissed as a normal phase, persistent or secondary bedwetting can signal underlying problems like bladder dysfunction, pediatric UTI, or even anatomical anomalies requiring evaluation by a specialized pediatric urologist in Nagpur.
Early intervention is crucial not only for the child’s physical health but also to prevent emotional stress and social embarrassment.
Types of Bedwetting
- Primary Nocturnal Enuresis
- Child has never had a sustained dry period
- Usually due to delayed bladder maturity or deep sleep patterns
- Secondary Nocturnal Enuresis
- Bedwetting returns after six months of being dry
- Often linked to stress, UTI, or medical conditions like diabetes or bladder dysfunction
Common Causes of Bedwetting
- Delayed neurological development – child may not feel bladder fullness during sleep
- Overproduction of urine at night – due to low levels of antidiuretic hormone
- Small functional bladder capacity
- Deep sleeping habits – child doesn’t wake up to bladder signals
- Family history – strong genetic link
- Constipation – puts pressure on the bladder
- Urinary tract infection (UTI) – may also cause foul-smelling urine, dysuria, or fever
- Stress, anxiety, or major life changes
- Underlying structural or functional issues like:
- Dysfunctional voiding in children
- Hypospadias, neurogenic bladder, or posterior urethral valves
- Child nephrolithiasis (kidney stones) causing irritation and urgency
Symptoms to Monitor Alongside Bedwetting
- Foul-smelling urine
- Painful urination (dysuria)
- Daytime urgency or daytime wetting
- Frequent urination or dribbling
- Constipation or abdominal discomfort
- Blood in urine
- Child fever indicating infection
These are red flags pointing toward an underlying urological condition that should be evaluated promptly.
Diagnosis: What a Pediatric Urologist Will Check
At a pediatric urology clinic, a thorough evaluation includes:
- History & frequency chart – bedwetting pattern, fluid intake, family history
- Physical examination – abdominal, genital, and neurological assessment
- Urinalysis and culture – rule out UTI or glucose (diabetes)
- Ultrasound (KUB) – checks for hydronephrosis, bladder capacity, or stones
- Uroflowmetry and post-void residual – bladder function and retention analysis
- Spine imaging (if needed) – to rule out spinal cord defects
If any signs of bladder outlet obstruction, neurogenic bladder, or anatomical malformations are present, further investigation is done.
Treatment Options for Bedwetting
Lifestyle & Behavioral Therapy
- Encourage urinating before bedtime
- Limit fluids 2 hours before sleep
- Avoid caffeine and carbonated drinks
- Toilet schedule during the day
- Reward systems (star charts) for motivation
Alarm Therapy
- Enuresis alarms help condition the child to wake up at the first sign of urination
- Works well in motivated families with consistent usage
Medications
- Desmopressin (DDAVP) – reduces nighttime urine production
- Anticholinergic drugs (e.g., Oxybutynin) – for overactive bladder
- Antibiotics – if pediatric UTI or foul-smelling urine is detected
Treating Underlying Conditions
- Constipation management – fiber, hydration, stool softeners
- Surgical correction – if hypospadias, PUV, or reflux is found
- Bladder retraining and urotherapy for dysfunctional voiding
Emotional Impact & Parental Support
- Reassure the child – it’s not their fault
- Avoid punishment or humiliation
- Involve the child in clean-up routines in a supportive way
- Seek psychological help if stress or trauma is suspected
When to Consult a Pediatric Urologist in Nagpur
You should seek expert care from a pediatric urologist like Dr. Sadashiv Bhole if your child:
- Is older than 5–6 years and continues to wet the bed
- Has associated symptoms like foul-smelling urine, UTI, or daytime wetting
- Was dry previously and starts bedwetting again (secondary enuresis)
- Has poor urine stream, dribbling, or other signs of urinary obstruction
- Shows signs of kidney involvement or spinal abnormalities
Bedwetting is not just a “habit”—it can be a sign of deeper urological or neurological issues. Timely intervention can restore confidence, prevent kidney complications, and eliminate emotional trauma.
If your child is struggling with nighttime wetting, foul-smelling urine, or repeated UTIs, consult Dr. Sadashiv Bhole, Nagpur’s leading pediatric urologist, for comprehensive, compassionate, and advanced care.
