Frequent Bedwetting in Sixth Graders: When to Seek Medical Help?

Frequent bedwetting occurs in sixth-grade elementary school students?

Hello, is it normal for a sixth grader to frequently wet their pants while awake? Which specialist should I consult? When I ask the child if they feel the urge to urinate, they say they do, but they still wet themselves.
What kind of specialist should I take them to?

Wan Jun, 30~39 year old female. Ask Date: 2017/06/05

Dr. Chen Taicheng reply Family Medicine

● Bedwetting after the age of ten may indicate an underlying issue, particularly more common in boys.
● There are many causes of bedwetting: (1) Immature brain development: Generally, if a person has a strong urge to urinate, they will wake up to go to the bathroom.
(2) Insufficient nocturnal vasopressin (an antidiuretic hormone), leading to nocturnal polyuria (for example, bedwetting in the first half of the night or more than two episodes of nighttime urination), which may contribute to bedwetting.
(3) Small or overactive bladder.
(4) Genetic factors.
(5) Organic factors: such as urinary tract infections, abnormalities in the urinary system, obstructive uropathy, or pediatric sleep apnea.
(6) Psychological factors: various sources of stress, etc.
● Before the appointment, parents should record the frequency of bedwetting each week, the number of episodes each night, the volume of urine each time, the frequency and volume of daytime urination, and fluid intake.
● Limit fluid intake 1-2 hours before bedtime, and avoid diuretic teas or caffeinated beverages; maintain a regular daytime urination schedule (frequent urination during the day may still indicate a problem).
● Please consult a pediatric (urology) specialist.
● Wishing your child good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares for you~

Reply Date: 2017/06/05

More Info

Frequent bedwetting, also known as nocturnal enuresis, can be a concerning issue for parents of sixth graders. While it is relatively common in younger children, it can persist into later childhood and even adolescence. In your case, the fact that your child is experiencing bedwetting during the day while awake raises some important considerations.

First, it is essential to understand that bedwetting can have various causes, including physiological, psychological, and developmental factors. In many cases, children may not have fully developed bladder control or may have a smaller bladder capacity. However, if your child is aware of the need to urinate but still has accidents, this could indicate an underlying issue that may require medical attention.

Here are some potential causes of daytime wetting in children:
1. Bladder Dysfunction: This can include conditions such as overactive bladder, where the bladder contracts involuntarily, leading to frequent urges and accidents.

2. Urinary Tract Infections (UTIs): UTIs can cause increased urgency and frequency of urination, sometimes leading to accidents. Symptoms may include burning during urination, cloudy urine, or abdominal pain.

3. Constipation: Chronic constipation can put pressure on the bladder and lead to urinary issues. If your child is experiencing bowel problems, this could be a contributing factor.

4. Psychological Factors: Stress or anxiety can manifest in various ways, including changes in bladder control. If there have been recent changes in your child's life, such as moving to a new school or family issues, this could be a factor.

5. Medical Conditions: Conditions such as diabetes or neurological disorders can also lead to changes in urination patterns.

Given your child's situation, it is advisable to seek medical help. The first step would be to consult a pediatrician, who can conduct a thorough evaluation. They may ask about your child's medical history, perform a physical examination, and possibly conduct urine tests to rule out infections or other medical conditions.

If necessary, the pediatrician may refer you to a pediatric urologist or a specialist in pediatric nephrology for further evaluation and management. These specialists can provide more targeted assessments and treatment options based on the underlying cause of the bedwetting.

In the meantime, here are some tips that may help manage the situation:
- Encourage Regular Bathroom Visits: Remind your child to use the bathroom regularly, especially before bedtime.

- Limit Fluid Intake Before Bed: Reducing the amount of fluid your child drinks in the evening can help minimize nighttime accidents.

- Positive Reinforcement: Encourage and praise your child for dry nights, and avoid punishment for accidents, as this can increase anxiety.

- Use Protective Bedding: Consider using waterproof mattress protectors to make cleanup easier and reduce stress for both you and your child.

In conclusion, while bedwetting can be a common issue in children, the specific circumstances you've described warrant further investigation. Seeking medical advice is the best course of action to ensure that any underlying issues are addressed and to provide your child with the support they need.

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