Tonsils and Bedwetting

Interesting study indicating that about half of the bedwetters (ages 5 to 18) with breathing difficulties while asleep (apnea or snoring) stop wetting the bed after a tonsilectomy. Those who stopped wetting “had significantly more arousals and obstructive apnea episodes but fewer awakenings than” those who continued to wet.

Confirming again a connection between sleep patterns and bedwetting.

Treatments

I haven’t had any luck with medication for bedwetting.

Immature anatomy isn’t the reason I wet the bed. My anatomy matured enough that I stopped wetting the bed when I was very little. Consequently, drugs that overcome late development (low hormones, small bladder, …) have no effect (or even a negative effect) on my bedwetting. Given the side effects (some of which are quite nasty) and the fact that I have to wear protection anyway, I have given up on trying to control my bedwetting with drugs.

However, there are drugs — DDAVP, Ditropan, Levsin or Tofranil — that are effective to treat many common causes. Some have nasty side effects, and their effect on bedwetting tends to diminish with extended use. But they can help control bedwetting, particularly for short periods. They can significantly cut the risk of a wet bed (or sleeping bag) on a sleepover or for a few days away from home.

College: Doctors

I went to student health services when I started wetting the bed again in college.

The SHS doctor was completely useless and unprofessional. He didn’t bother to examine me. He didn’t bother to take a proper history, even though I told him that I had been a chronic bedwetter as a teenager, and had been extensively tested and examined by urologists, neurologists and endocrinologists. I even used the mystical phrase, “secondary enuresis”.

He didn’t ask me the obvious questions that my family doctor had asked and he didn’t ask about the tests that I had as a teenager. Nor did he order any tests for diabetes or other potential causes.

He told me that college bedwetting was psychological and that I should see a shrink. I told him that I didn’t need a shrink — I was happy with my life, getting straight A’s, and ahead on all my classes. I had lots of friends and an active and satisfying social and love life. I wasn’t stressed or anxious about anything.

He didn’t pay any attention. He wrote me a prescription for one of the drugs that had been ineffective for me as a teenager. He also wrote me an authorization for sessions with a psychiatrist.

I left the exam room and tore up the prescription and the psychiatrist authorization.

One of the nurses saw how upset I was. She took me into an exam room. When I told her what was upsetting me, she laughed — She had assumed that I had just been told I was pregnant.

She told me that I was not the only student who wet the bed. If I had noted it on my freshman questionnaire, the college would have offered me my own room or a bedwetting roommate. She could arrange a change in my rooming and could provide me with briefs (she didn’t use the d-word).

I didn’t want to change my rooming. I told the nurse that it wasn’t going to be a problem. I had practice discreetly changing during my first semester and when I had to deal with an occasional wet bed. But I would definitely take the briefs.

The nurse also arranged for me to see a urologist, who was everything the SHS doctor was not. We had a long conversation, and he consulted with my family doctor and the specialists I had seen as a teenager. He did the urological tests on me, but I did not want to endure all the testing that I had as a teenager.

High School: Doctors

After I wet the bed the second time as a teenager, I went to see our family doctor.

It was awkward. He was the father of one of my best friends. His nurse was the mother of one of my childhood babysitters. However, they were sympathetic and completely professional.

Even though I was only 14 and a straight-arrow kid, the doctor went through the obvious questions: Stress? Fatigue? Depression? Anxiety? Drugs? Alcohol? Cigarettes? Unusually thirsty? Snore at night? Coffee, cola or tea at night? Prescriptions from other doctors? Nonprescription medicines? Big tests or athletic events around days after I wet?

No, no, no …

Did I menstruate? Yes. For how long? A couple of years. Changes in menstruation? No.

How heavy a wetting? Very.

What time? Between 2 and 4 AM.

Drink anything before bed? Just water. How much? A glass. How close to bedtime? Right before. What did I have for dinner? Different things.

He gave me the medical name for bedwetting — enuresis — but cautioned that it was just a name for a symptom.

He ran tests that ruled out some potential causes (diabetes and urinary tract infection), and referred me to the nearest medical center. He wouldn’t have been concerned if I had been wetting the bed regularly — even as a teenager — without ever having been dry (primary enuresis). That is usually simply late development of hormones or bladder capacity. But wetting the bed after being dry for over 10 years was a sign of something more serious than immature anatomy.

I saw urologists, neurologists and endocrinologists. They ran test after test: cystoscopies, urograms, urodynamics, ultrasounds, EEG’s. I had a sleep study and a spinal tap.

The urological tests were extremely unpleasant (although not the screaming pain of the spinal tap), and left me completely, gushingly incontinent for hours.

They prescribed various drugs. The little red pills made my heart race and made the wetting worse. The nose spray cut down on the frequency and volume, but the side effects were awful. I still wet the bed at least three times a week. Since I still needed protection, I quit using the drugs.

After a year of testing and no diagnosis, I gave up on it. It wasn’t finding anything and I was tired of getting poked at. I decided I would just live with it and wear a diaper.

All the doctors agreed that a diaper was an appropriate palliative. My bedwetting was a symptom of a medical issue, not a sign of immaturity. I had plenty of incentive without being forced to wake up in a pool of urine. A diaper was a practical solution.

When to see a doctor

Right after I wet the bed the second time as a teenager, Mom scheduled an appointment with our family doctor. Wetting the bed at 14 after being dry for ten years (secondary enuresis) is a symptom of something serious.

Mom didn’t make special appointments with the doctor for the other kids’ bedwetting. They had always wet the bed (primary enuresis), so everyone assumed that the cause was hormones or bladder volume. Mom discussed it with the doctor at every annual checkup, but until they were 10, it was just to reassure my brother or sister that it wasn’t a big deal and he or she would outgrow it. When their bedwetting continued into junior high school, they got some of the tests I got.

I’ve told my kids’ pediatrician about my own and my siblings’ bedwetting.

If a child wets the bed after age 6, you should be on the lookout for other symptoms that may indicate something more serious than hormones or immature bladder — such as urinary tract infection, diabetes, apnea or epilepsy.