Sickle Cell Disease – Chronic Complications Bedwetting

Download leaflet

Haematology Department Sickle Cell Disease – Chronic Complications Bedwetting Information for parents and carers (265kB vnd.openxmlformats-officedocument.wordprocessingml.document)

Introduction

This leaflet is designed to explain about the long term (chronic) complications of sickle cell disease. The information does not cover everything. If you are ever worried about your child then please contact your Sickle Cell Team or take your child to Accident and Emergency Department

Is bedwetting common?

Bedwetting is very common in children and young people. Many children grow out of it although this can take years. The medical term for bedwetting is nocturnal enuresis.

Why does my child have enuresis?

The kidneys do not work as effectively due to sickle cell cells getting trapped in the small blood vessels of the kidney and damaging it. This means that the kidneys do not concentrate urine as much as normal so children with sickle cell disease need to pass large quantities of diluted urine. This can lead to them getting dehydrated so they need to drink more and this can lead to bed wetting at night. At night when your child is asleep they may not be aware that their bladder is full so will wet their bed.

Is enuresis a problem?

Children are usually dry at night by the age of four but for some children bedwetting can carry on until a later age.

Bedwetting can cause a child to get upset and embarrassed. Children may not want to join in with sleep-overs or overnight trips away. It can also put a strain on the family with parents having to get up during the night to change the bed as well as causing an increase in laundry.

If your child is wetting the bed more than once or twice a week by the age of six it is important to let you tell the Sickle Cell Team when you see them in clinic.

What can I do if my child wets the bed?

There are a few simple measures that you can try to see if it will stop your child bedwetting:

• Reassure your child, don’t get angry, blame or punish your child.
• Ensure that they go to the toilet before they go to bed.
• Get your child up to use the toilet at regular intervals during the night.
• Encourage your child to use the toilet regularly throughout the day – about four to seven times.
• Put a plastic mattress cover on their bed.
• Try to get your child to drink more fluid during the day and less in the evenings.
• Try a star chart not just for dry nights but also for using the toilet before bed time, drinking the right amount throughout the day and helping to change the sheets.
• Tell your Sickle Cell Team when you attend clinic.

Does enuresis just occur at night?

Some children have problems with enuresis during the day time. They can experience incontinence, urgency and increased frequency of needing to pass urine during the day.

What is the treatment for enuresis?

If you report that your child has enuresis we will take a urine sample to check that they don’t have a urine infection, that they aren’t leaking any protein and to see how well they are concentrating their urine. If they have a urine infection they will be given a course of antibiotics. If we find that your child’s kidneys aren’t working properly we will refer them to the nephrology (kidney) doctors for review.

If this isn’t the cause for your child’s enuresis they will be referred to the enuresis team for management. You will be given practical tips for your child to try if this does not work then there are other things that can be tried:

• Bedwetting alarms – alarms detect when wetting starts and make a noise and/or vibrates to wake the child up.
• Medicine – a medicine called Desmopressin. Desmopressin works by making the urine more concentrated, reducing the amount of urine produced overnight. Your child should not drink after they have taken Desmopressin so this may not be a suitable option for your child. It also needs to be stopped if your child is having a sickle cell crisis.

Further information

If you need any further information please contact your Sickle Cell Team on 0151 252 5070

Useful websites

www.sicklecellsociety.co.uk

www.eric.org.uk

http://guidance.nice.org.uk/CG111/PublicInfo/pdf/English

Alder Hey Children’s NHS Foundation Trust is neither liable for the contents of any external internet site listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 0047