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Bedwetting
Bed Wetting
(Nocturnal Enuresis)
What is bed wetting?
Bed wetting, which is also called nocturnal enuresis (NE), is the involuntary passage of urine while asleep. Inherent in the definition of NE is satisfactory bladder control while the child is awake.
Are there types of nocturnal enuresis (NE)?
Two types of NE occur: - Primary enuresis - bed wetting since infancy; and
- Secondary enuresis - wetting developed after being continually dry for a minimum of six months.
What is primary nocturnal enuresis (NE)?
Primary NE is generally viewed as a delay in neurological maturation. At 5 years of age approximately 20% of children wet the bed at least once a month with about 5% of males and 1% of females wetting nightly. By 6 years of age only about 10% of children are bedwetters - the large majority being boys. The percentage of all children who are bedwetters continues to diminish by 50% each year after 5 years of age. A strong family history of primary NE is well known. If one parent was a bedwetter, the offspring have a 45% chance of a similar plight condition.
What is the basic problem in primary NE?
The fundamental problem faced by children with primary NE rests in the inability while asleep to recognize neurologic messages sent by the full bladder to the sleep arousal centers of the brain. In addition, bladder capacity is often smaller in NE children than in their peers.
Is primary nocturnal enuresis (NE) due to emotional problems?
Parents sometimes believe that their childıs primary NE is emotional. No medical or scientific literature exists to support this impression.
How is primary nocturnal enuresis (NE) treated?
The "cure" for primary NE is "tincture (or passage) of time." However, since many parents and children are appropriately frustrated with bed wetting as it starts to interfere with self esteem or social events (e.g. sleepovers), a step by step approach can be anticipated to have a successful outcome in over 75% of such patients.
An excellent text (Waking Up Dry: How to End Bed wetting Forever, Martin Scarf, Ph.D., Writerıs Digest Books, 1986) provides parents with children who are motivated to overcome bed wetting a behavioral approach utilizing "bladder stretching" exercises and instructions in alarms. The book also provides an overview of the various medications available by prescription for treating NE.
How common is secondary nocturnal enuresis?
Only approximately 2%-3% of all children with NE have a medical cause for the condition.
What causes secondary nocturnal enuresis?
Urinary tract infections, metabolic disorders (e.g. various types of diabetes), external pressure on the bladder (e.g. extreme constipation by a large rectal stool mass) as well as neurologic disorders of the spinal cord must be considered among the causes of secondary NE.
How is the cause of secondary NE diagnosed?
Generally, a complete history and thorough physical exam provide the initial evaluation of a child with primary NE. A urinalysis and urine culture generally complete the work. Further laboratory and radiological studies are usually reserved for the youngster who presents with secondary NE.
What is the treatment for secondary NE?
Therapy of secondary NE is directed at the primary pathology provoking the symptom of wetting the bed. As expected, cure rates vary with the primary cause of the loss of control.
What is the outlook (prognosis) for children with bed wetting?
In the medical world of today, both primary and secondary NE should be a manageable condition with a reasonable goal of successfully eliminating both parental and patient anxiety, frustration and embarrassment. - Bed wetting is also called nocturnal enuresis.
- There are 2 types of nocturnal enuresis: primary and secondary.
- Primary nocturnal enuresis is bed wetting since infancy.
- Primary nocturnal enuresis is due to a delay in the maturing of the nervous system.
- Primary nocturnal enuresis is an inability to recognize messages sent by the bladder to the sleeping brain.
- The "cure" for primary nocturnal enuresis is "tincture (or passage) of time."
- An excellent book on bed wetting is recommended.
- Secondary nocturnal enuresis is wetting after being dry for at least 6 months.
- Secondary nocturnal enuresis is due to urine infections, diabetes, and other medical conditions.
- All bed wetting is manageable.
Last updated on 07/03/2008
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