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Night urination in children and the role of psychotherapy

Autor: dr Dragan Zlatanović   


Night urination is a disorder which occurs in children after four years of age; it is characterized by the inability to control the process of urination while sleeping. Despite the disorder, all the organs of the genital-urinary system are healthy and they function normally.

How does child react to this disorder?

This disorder brings about a permanent frustration in children and the expressed feeling of embarrassment. At that moment, what is most important to children is that their friends never find out about their problem. Sometimes, they hide the problem from their own parents, too. Younger children, very often try to conceal the urinated underwear. Older children, on the other hand, secretly wash the urinated underwear and pajamas. Some children are indifferent to the problem, whereas others are depressive.

Which children suffer from this disorder?

About 15% of children urinate in bed after three years of age; night urination in boys is from 1,5 to 2 times more often than in girls, and it usually occurs within those families in which at least one member had the same problem in its childhood. Occasional night urination can happen especially when the child is ill. The frequency of night urination is different. The greatest number of children urinate once, but some of them do that more than one time.

When does night urination occur?

Night urination can be classified into primary and secondary. Primary urination comprises daily and night urinations, which haven’t stopped since birth; secondary (acquired) urination, which is rarer, occurs after the period of “cleanness”, or the “dry” period.

The disorder is usually related to sensitive factors and conditions within the family surrounding, which, in various ways, influence the organization of this function.
Night urination can sometimes be related to sleeping disorder of a child.

Why does night urination occur?

In most of the cases, it occurs due to the child’s weak bladder. Also, it can come to disorder in an emotionally disturbed child. For example, when a little child starts urinating in bed (although it was dry for months or years before that), it is probably its reflection to daily fear or insecurity. Children can feel insecure or scared because of numerous reasons:
  • because of moving to another place;
  • because of the parents’ divorce;
  • because of the loss of a family member or a close person;
  • because of the brother’s or sister’s birth.

How to solve the problem of night urination?

Parents should have in mind that children very rarely or never urinate in bed on purpose. Instead of criticizing or beating the child, they should encourage and support their child to stop doing that. It is important that parents comply with certain rules. They should especially pay attention to consummation of liquid before the bed time; they should praise the child whenever it wakes up dry in the morning; they should avoid any kind of punishment; they should wake up their child to urinate during the night; they should consult the doctor if necessary, so that the child could get an adequate therapy. Some children are not motivated enough to cure themselves. They claim they don’t bother the urinated bed. In order to motivate them to cooperate, parents should make them change their bed linen every morning by themselves. It is not a punishment that should be imposed to the child in the form of order or reprimand. Parents should ask their child to do this; when the child gets bored with it, it might happen that it stops urinating in bed or does that rarely. Once released from this task, the children feel awarded and more motivated to be cured. If you consult your doctor or psychologist in due time, you have better chances to solve this problem.

Dragan Zlatanovic, MD

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