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Dr Catherine
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Girl
4-7 years

Dear N.W., your daughter is experiencing secondary enuresis which describes the condition where children had proper control over their bladder during the night for a period of six months or more then begins to wet again. Secondary bedwetting appears to have two main causes: physical and psychological. Physical or medical causes can include such things as urinary tract infections or chronic constipation. Given your daughter has been on life-support and therefore catherterised, she may actually have a urinary tract infection which would need to be ruled out first. The majority of secondary bedwetting results from emotional problems or psychological stress. All children react differently to stress. Signs of stress include physical symptoms such as ongoing headaches and stomach aches, vomiting as well as nighttime or daytime wetting. Hospitalisation can be incredibly stressful for young children, she's in a foreign environment, separated from familiar surroundings, separated from her parents and encountering lots of different adults whom she does not know. When there are significant emotional or social stressors associated with secondary bedwetting, then attention to these issues should take priority over the different treatments for bedwetting. If there are no apparent ongoing psychological issues then the treatment options are the same as those recommend for children experiencing primary bedwetting. Take your time with her, keep things as familiar and constant as possible and ensure that she feels loved and special. Regards, Dr Cathrine