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  • Before an enuresis specialist decides how to approach treatment for each individual patient, an accurate diagnosis must be determined. There are several possible causes for bedwetting (medical, psychological and restraint learning fault). Although the learning fault is the most common cause (the case for about 90% of patients) and it is much less of a change the cause is psychological (about 10%) or medical (about 1%), the diagnosis is biased and strongly depends on the therapist area of specialty.
    Many pediatricians and urologists will perform a thorough and comprehensive medical evaluation including invasive tests. They will seek a medical cause for the condition, even though the probability of this is very slim. Medical causes for enuresis can be ruled out right away if the child only wets during sleep and is dry during the day and should not require those uncomfortable exams.
    The psychologist will look for a psychological cause although this is the case within only about 10% of bedwetters.
    A wrong diagnosis will lead to wrong and ineffective treatment.
    I had a bedwetting patient, age 12, who was previously treated for 3 years by a psychologist. This poor boy didn't have any psychological issues; his academic and social performance was very good; the family was very supportive and he didn't have any symptoms that will lead to the conclusion of any psychological cause. He was seen by a psychologist on a weekly basis with no improvement. It is needless to say that the treatment was harmful since the boy lost confidence in his ability to become dry, not to mention the lost years and lose of time and money.
    The same is true when medical treatment is performed when it isn't needed. A 25 year old woman was told by her Urologist that only an operation will solve her bedwetting issue. She was treated in my clinic and outgrew bedwetting in 4 months.
    Parents should feel free to ask for an explanation about why a certain treatment is being recommended or to seek second opinion and not to blindly accept everything they are being told.