Friday, August 2, 2013

The causes for bedwetting by Dr. Sagie

The conventional train of thought among both parents and many pediatricians is that bedwetting is a medical or psychological problem. Often, the patient undergoes a comprehensive and unnecessary medical assessment with no findings. However a medical, neurological or urological, problem is only the primary diagnosis among 2% of enuretics. A psychological cause, such as family problems, social adjustment, or fears is a factor among an additional 20-25% of the patients.
In fact, the majority of enuretics (75-80%) do not have either anatomical or psychological problems. For most enuretics the primary source of the issue is unusually deep sleep.  These are normal, healthy children who have not learned to activate the appropriate reflex system during sleep. Typically, when a person sleeps and pressure is built up inside the bladder, a signal is sent to the brain. Among enuretics, the signal is not recognized by the sub-conscious reflex system and instead of contracting the sphincter muscle, the circular muscle that keeps the bowel closed, the child relaxes the muscle and urinates during sleep.

Wednesday, July 31, 2013

Understanding the Enuretic child by Dr. Jacob Sagie and Tal Sagie

Knowing the causes for bedwetting is not enough. It is essential that the parents will understand what it is like to be a child with a bedwetting problem. Since it is a genetic issue, many parents have suffered from bedwetting themselves. Even this is not enough of a preparation to deal with their child's issue.
What is going in an enuretic child's mind? The following story will illustrate the typical situation;
I received a phone call from an ex-patient who is 25 years old. He told me that when he was 9 years old he came with his parents to my bedwetting clinic. His parents accused him of not trying hard enough to deal with the problem and then he reminded me of my response to his parents: "What do you want from him? Why do you blame him? He does not wet the bed on purpose; he doesn't feel when he is wetting the bed". The young man said, “For the first time in my life, I felt that someone understood me". Although many years passed since this meeting, he remembered every single detail from this session and was so grateful. By the way, he outgrew bedwetting after only 3 months of treatment.

If parents will realize what is going on in their child's mind they will certainly act differently by showing understanding, sensitivity, empathy and support.