Welcome to Children's Urology of Virginia
Patient Portal
Home
About Us
Contact Us
Site Map
Patient Lobby
FAQs
Insurance Billing
Appointments
Referrals
Privacy Policy
Site Map
Suggestion Box
Search Our Site:


Site Map


Enuresis
 
This is an abbreviated version of the complete article.*
Basic Facts
Enuresis is a child's involuntary release of urine at an age when he or she should be able to control urinary function.
Nocturnal enuresis (enuresis that occurs at night) is the most common form of enuresis.
In most cases, children with enuresis are physically and psychologically normal
The kidneys, ureters, bladder, and urethra make up the urinary tract.
The kidneys, ureters, bladder, and urethra make up the urinary tract.
Enuresis is a child's involuntary release of urine at an age when he or she should be able to control urinary function. Usually the child is around age 5 or 6. Enuresis can occur during the day, referred to as diurnal enuresis. More commonly, enuresis occurs at night, which is called nocturnal enuresis or bedwetting. Enuresis is a normal part of development and most children outgrow it. Enuresis rarely has an underlying physical cause.

Nocturnal enuresis is categorized into two types. A child can either have primary nocturnal enuresis, in which he or she has never learned to control his or her bladder functions and eventually outgrows the bedwetting. Or a child can have secondary nocturnal enuresis, in which he or she has learned bladder control but develops enuresis again after 6 months of staying dry.

Enuresis is not painful; however, it can embarrass children, create anxiety, diminish self-esteem, and prevent children from developing social relationships.

Because nocturnal enuresis is involuntary, the child should never be punished.

WHAT ARE THE SYMPTOMS?

Nocturnal enuresis is neither a condition nor an illness; therefore, it has no symptoms.

CAUSES AND RISK FACTORS

The majority of children who wet the bed at night are physically healthy and emotionally sound. Although physicians do not know a definitive cause, they have many theories to explain the primary nocturnal enuresis, including:
  • Delay in physical development; and
  • Low levels of arginine vasopressin.
Causes of secondary nocturnal enuresis may include:
  • Overactive bladder;
  • Anxiety or stress.
Approximately 1 percent of enuresis cases may be caused by a physical problem such as:
  • Urinary tract infection;
  • Constipation;
  • Neurogenic bladder;
  • Obstructive sleep apnea;
  • An obstruction in the urethra or ureter;
  • Diabetes mellitus;
  • Diabetes insipidus;
  • Heart block; or
  • Hyperthyroidism.
In these cases, nocturnal enuresis may be a symptom of the underlying condition or disorder.

Children are at greater risk for enuresis if their parents also experienced enuresis as a child. Generally, children will stop wetting the bed at night around the same age that their parents stopped.

DIAGNOSIS

The physician will conduct a history and physical examination. He or she may instruct the parents and child to keep a voiding diary for 1 to 2 weeks.

If the physician suspects that the bedwetting may be caused by an underlying condition or illness, he or she may order a urinalysis or an x ray. Other tests that may be performed include:
  • Voiding cystourethrogram (VCUG);
  • Cystoscopy;
  • Magnetic resonance imaging (MRI);
  • Urine flow study; or
  • Electrocardiogram (ECG).
TREATMENT APPROACH

Nocturnal enuresis is usually not considered a problem until the child reaches the age when he or she should be able to control urination, usually around age 5 or 6. If the physician decides that a treatment approach is necessary, he or she may begin with behavior modification techniques, such as:
  • Alarm therapy;
  • Bladder training; or
  • Responsibility reinforcement.
For children who do not improve with behavior modification after 1 month, the physician may recommend one of the following medications:
  • Desmopressin acetate (DDAVP);
  • Imipramine; or
  • Anticholinergic therapy.
*If you would like to read this article in its entirety, please call our office and ask to meet with one of our specialists to receive a Prescription Pad form.

*If you already have a Prescription Pad form, please login and follow the instructions listed on the form. If you experience any issues during the registration process, please call member services at 1-800-603-1420 for assistance.
Copyright © 2014 NorthPoint Domain, Inc. All rights reserved.
This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain's Content is an infringement of the copyright holder's rights.
Terms and Conditions   |   Feedback   |   Privacy Statement

Developed and hosted by Urology Domain.
© Copyright 2000-2014. NorthPoint Domain Inc. All rights reserved.
ICS-PR-WEB02