What is enuresis?
Normal urinary control is usually established by 3 to 4 years of age. Lack of voluntary urinary control (wetting) in a child beyond 5 years of age is called enuresis. When this occurs only when the child is sleeping (bed-wetting), the condition is called sleep enuresis (or nocturnal enuresis)
Is enuresis common?
Yes. Approximately 15 to 20 of every 100 healthy children still wet the bed while sleeping at 5years of age, and approximately 5% to 10% of children still wet the bed while sleeping at 10 years of age.
What causes enuresis?
While there are many theories, the exact etiology of enuresis is unknown. In most children, enuresis represents a delay in the normal process of developing bladder control. With some children, there is a strong family history of sleep enuresis, which may play an important role. A small percentage of children have an anatomic abnormality of the urinary tract that is responsible for their poor bladder control.
Does my child need to see a doctor?
Yes. All children with enuresis should have a physical examination and a urinalysis. When the examination is entirely normal and the child has not had a urinary tract infection (UTI), additional testing is typically unnecessary.
Does my child have a serious physical problem?
Only a small percentage of enuretic children have a physical problem with their bladder or kidneys. These children usually have had a UTI or have bladder control problems both day and night (or both). Children who wet the bed only while asleep and who urinate normally during the day rarely have a physically problem.
Does my child need x-ray studies?
Kidney and bladder x-rays are typically unnecessary, and are usually performed only when there is a history of UTI or day and night wetting.
Does my child have an emotional problem?
Emotional stress is rarely the cause of enuresis. Children with an emotional problem usually have established normal urinary control for 6 months to a year or more, then subsequently lose control and start to wet again (a condition called secondary enuresis). Such children often have recent identifiable stress in their lives (such as moving, school change, death, divorce, or the birth of new siblings).
When a child has never established normal urinary control (so-called primary enuresis), it is uncommon that a psychological problem is to blame. Children with enuresis often feel shame, guilt and frustration, which may cause the subsequent development of emotional problems, are not the primary cause of enuresis, but instead, a result of the wetting. These problems can be minimised by giving these children appropriate support and understanding.