|
Normal Urinary Control In Infancy
Causes of Primary Enuresis (Bedwetting)
- Developmental disorder or maturational delay
- Decreased functional bladder capacity
- Uninhibitted bladder contractions
- Bedwetters have strong bladder contractions
- Genetic predisposition - 1 parent 40% likely, both parents 77% chance
- Sleep disorders
Causes of Secondary Enuresis
- Urinary tract abnormalities
- Possible diabetes diagnosis
- Psychological factors - new baby, negative attention
Causes of Nocturnal Enuresis (Night Bedwetting)
- Urinary Incontinence during sleep
- Primary; never experience a period of dryness (2-3 months) without treatment are 90% of bedwetters
- Secondary; child has stopped bedwetting for at least 6 months, then resumes
|
 |
Purpose of Behavioral Management Within Treatments
To teach bowel and bladder habits with emphasis on complete emptying of the bladder to restore bladder homeostasis and reduce the risk of UTI and renal scarring.
Dysfunctional Elimination
This occurs in children when the pelvic floor muscles (PFM) do not work together with the bladder and the normal voiding reflexes are disrupted. This leads to a chronic abnormal pattern of voiding, which does not allow the bladder to empty completely. Some children experience difficulty urinating or controlling their bladder function. Symptoms can include frequent bladder infections, constipation, not urinating enough during the day or not sensing bladder fullness. Children can have urinary leakage during the day or wake up wet in the morning or both. Physical therapy can help relax and retain the pelvic floor muscles in the child.
Constipation
In children this increases the likelihood of urinary incontinence, bladder overactivity, poor emptying of the bladder, recurrent UTI and deterioration of vesicoureteral reflex.
|
