Primary Bedwetting VS Secondary Bedwetting

Bedwetting, a common phenomenon to the kids, is declined with age. Ten percent kids below six years are bed wetters whereas the number reduces to a three percentage in the case of 14 years of age. On a very few cases, the bedwetting can happen in adulthood also.

The bedwetting is divided into two categories, Primary bedwetting and secondary bedwetting. Primary bedwetting is the bedwetting of a child during almost every night. Secondary bedwetting is the second stage of bedwetting started after a lengthy period of dryness.

Primary Nocturnal Enuresis - PNE

Primary bedwetting is supposed to be caused by many physical/neurologically immature urine bladders or due to the sound sleep. The children with deep sleep may ignore the warning from the bladder for voiding. This may leads to primary bedwetting. Primary bedwetting can also be caused by attention deficit disorder, allergies and other learning disabilities. Mental/physical stress can also create primary bedwetting; as the bed wetters need to be treated with more compassion. They almost all exempted from the sleeping-other-than-home activities to avoid shame. This primary bedwetting children also feel embarrassed due to the disorder and feels low esteem which in turn leads to delaying of overcoming bedwetting.

The primary bedwetting normally disappear with the age. The children’s brain normally matures to understand the signals from bladder, the muscles in the bladder become strong and the bladder size increases which lead to reduced need of urinating and subsequently nocturnal bedwetting. The primary bedwetting is treatable medically or behaviorally. Imipramine, a tri-cyclic antidepressant, is used to treat the bedwetting syndrome. The medicine helps to reduce the bedwetting, the symptom reappear on discontinuation of the drug. The drug has serious side effects and needs to be administrated by a medical practitioner.

Desmpressin acetate, an artificial antidiuretic hormone is used through nasal spray to reduce the production of urine during night. The reduced production of urine reduces the need of urinating and thus nocturnal enuresis. The symptom in this case too reappears on stopping of the medicine. Even though it is less harmful drug than impramine, still possess some side effects.

Behavioral treatment for primary bedwetting is a lengthy process but is safer and long lasting than the medical treatment. Retention control, waking up during night and moisture alarm is used in the behavioral treatment for primary bedwetting. The retention control training constitutes delaying of voiding during day time with gradual increase in the intervals. This gives more strength to the sphincter muscles. Waking the child during night is another way. Wake the child during night at regular intervals for voiding will assist in stopping primary bedwetting. The moisture alarm is also used in the treatment which is attached to the bed clothing and when the kid starts urinating, the alarm set off and wakes the child. The continued procedure will ultimately make the brain understand the need of responding to the signal from bladder which leads to reduced primary bedwetting.

Secondary Nocturnal Enuresis - SNE

Secondary bedwetting is the enuresis after a long gap of dryness. The causes of this secondary bedwetting are many. Neurogenic bladder, urinary tract infection, spinal cord anomalies, external urethral valves in boys and in girls, ectopic ureter are all the causes of secondary bedwetting. Secondary bedwetting needs to be medically examined to rule out any possibilities of these disorders and to be treated symptomatically.