Red flags & when to go in person for Bedwetting (Enuresis) - Management

Audience: pediatric

Bedwetting, also known as enuresis, is common in children and often improves with time. It usually happens during sleep and may be caused by factors like deep sleep, small bladder capacity, or delayed development. While many children outgrow bedwetting without treatment, some may need extra support or medical attention. Telemedicine can help families understand bedwetting, offer advice on managing it, and decide if further care is needed. However, certain warning signs mean it's important to see a healthcare provider in person. This guide explains when to seek in-person care, what telemedicine can and cannot do, and how to prepare for and follow up after a telemedicine visit.

Red flags — go in person / ER

• Sudden onset of bedwetting after 6 months of dryness — see healthcare provider promptly.
• Pain, burning, or blood during urination — seek in-person evaluation.
• High fever or signs of infection with bedwetting — go to urgent care or emergency.
• Frequent daytime urination or urgency — requires medical assessment.
• Constipation or bowel problems linked to bedwetting — consult healthcare provider.

What telemedicine can do

• Providing education about bedwetting causes and management.
• Reviewing symptoms and medical history remotely.
• Offering behavioral advice and support.
• Helping decide if in-person care is needed.

What telemedicine cannot do

• Performing physical examinations or urine tests.
• Diagnosing infections or other medical conditions.
• Managing emergencies or severe symptoms.
• Prescribing treatments requiring physical assessment.

What is Bedwetting (Enuresis)?

Bedwetting is when a child urinates during sleep after the age when they usually stay dry at night. It is common in children under 7 years old and often improves as they grow. Bedwetting can be due to a child's bladder not holding enough urine, deep sleep patterns, or delays in bladder control development. It is usually not caused by serious illness.

When to Seek In-Person Care

Most bedwetting cases don't require urgent medical visits. However, you should see a healthcare provider in person if your child has:

These signs may indicate an underlying condition that needs evaluation.

How Telemedicine Can Help

Telemedicine visits can provide education about bedwetting and its common causes. Healthcare providers can:

Telemedicine is a convenient way to get support without leaving home.

Limitations of Telemedicine for Bedwetting

Telemedicine cannot replace physical exams or urine tests that may be needed to rule out infections or other problems. If your child has red flags or if symptoms worsen, an in-person visit is important for proper diagnosis and treatment. Emergency symptoms like severe pain, high fever, or blood in urine require urgent care.

Preparing for a Telemedicine Visit

Before your telemedicine appointment:

This helps the provider give the best advice.

After the Telemedicine Visit

Follow the provider's recommendations carefully. This may include:

Keep track of progress and communicate any concerns promptly.

How to prepare for your tele-visit

• Track frequency and pattern of bedwetting episodes.
• Note any daytime urinary symptoms or related concerns.
• List all current medications and supplements.
• Prepare a quiet, private space for the telemedicine visit.
• Write down questions or concerns to discuss with the provider.

After your tele-visit

• Follow recommended behavioral strategies consistently.
• Monitor for any new or worsening symptoms.
• Schedule in-person follow-up if advised by the provider.
• Seek urgent care if red flag symptoms develop.
• Keep a symptom diary to share during future visits.

FAQs

Is bedwetting normal in children?

Yes, bedwetting is common in children, especially under 7 years old. Many children outgrow it naturally as their bladder control develops.

Can bedwetting be caused by serious illness?

Sometimes, bedwetting may be linked to infections or other health issues. Red flags like pain, blood in urine, or sudden changes should prompt medical evaluation.

What can I do at home to help my child?

You can limit fluids before bedtime, encourage regular bathroom use during the day, and be patient and supportive. Behavioral strategies often help.

When should I see a doctor in person?

If your child has sudden bedwetting after being dry, pain or burning during urination, blood in urine, fever, or daytime urinary symptoms, see a healthcare provider promptly.

Can telemedicine replace all care for bedwetting?

Telemedicine is helpful for education and advice but cannot replace physical exams or tests needed to diagnose some causes of bedwetting.

Sources

1. Bedwetting (Enuresis) in Children — MedlinePlus, U.S. National Library of Medicine.
2. Enuresis (Bedwetting) in Children — American Academy of Pediatrics.
3. Nocturnal Enuresis in Children: Clinical Practice Guideline — American Academy of Family Physicians.
4. Bedwetting (Enuresis) — Mayo Clinic.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has any concerning symptoms or red flags, please seek evaluation by a healthcare provider in person promptly.