Enuresis (Bedwetting) and Sickle Cell Disease

What is enuresis?

Enuresis (bedwetting) is urinating (peeing) when you do not intend to go. This is most common at night when a person is asleep. The medical term is nocturnal enuresis. Some people also have trouble controlling their pee when they are awake during the day. This is known as diurnal enuresis.

Many children and teens with sickle cell disease experience bedwetting. Some deal with it well into their teenage years.

Bedwetting occurs more often in people with sickle cell disease because:

• In sickle cell disease, the kidneys do not work as well to concentrate urine. This means you may make large amounts of watery urine that fills the bladder more quickly.
• People with sickle cell disease need to drink a lot of fluids to prevent pain crises.

Bedwetting will usually go away as your child ages. But nocturia (getting up during the night to go to the bathroom) may happen into adulthood.

Symptoms of enuresis

Symptoms of enuresis include:

• Having to pee more often during the day
• Inability to control when you pee
• Wetting the bed

Treatment for enuresis 

There are no standard medical treatments for bedwetting in patients with sickle cell disease. But there are ways to support your child and help manage enuresis and make bedwetting occur less often. The first step is to try to manage bedwetting with strategies based on your child’s age. In some cases, your care team may prescribe medicines.

Strategies to help bedwetting include:

• Reassure your child: Children often feel embarrassed about bedwetting, and it can be frustrating for caregivers. It is important let your child know that bedwetting is not their fault. Remember, your child can’t control bedwetting. Do not punish or shame your child.
• Manage fluid intake: Do not allow your child to drink fluids 2 hours before bedtime. Avoid giving your child drinks with caffeine, especially at night.
• Set an alarm: Set an alarm and wake your child to go to the bathroom during the night. Talk to your care team about using a bedwetting sensor alarm.
  
• Use absorbent bed pads or diapers: Find ways to make clean up easy for you and your child if bedwetting occurs. This can help reduce stress and anxiety.
  
• Create a toilet routine: Be sure your child uses the toilet at regular times in their schedule such as when they wake up, during breaks, after meals, and before going to bed.
  

These tips can help. But they may not work all the time. It may also help to speak with a psychologist or counselor about bedwetting.

Talk to your care team if enuresis does not improve after trying these strategies for a few weeks. Do not give your child any medicine for bedwetting without talking to the care team first. 

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