Enuresis refers to the repeated inability to control urination. This term is used almost exclusively to describe nocturnal urinary incontinence in children and youths aged 5-17. Nocturnal enuresis is commonly known as “bedwetting”, or “pipi au lit” in French.
How common is enuresis?
Although enuresis can be unsettling for children and their families it is among the most common of pediatric health concerns. Boys are three times as likely to wet the bed as are girls. At age 5 approximately 20% of children experience enuresis or frequent bedwetting. At age six that figure is reduced to approximately 10-15%.
What causes enuresis?
Nocturnal enuresis is diagnosed when a child older than 5 years experiences two or more bedwetting incidents per month. The vast majority of cases are thought to be physiological, rather than psychological, in nature. Other conditions which may cause urinary incontinence (spinal injury, urinary tract infections, etc.) must be ruled out. When no underlying disease is found it’s usually the case that the child is unable to recognize and be awakened by the sensation of a full bladder. This common neurological developmental delay is nearly always outgrown. Enuresis has a strong genetic component. When neither parent has experienced enuresis or frequent bedwetting the child has a 15% chance of bedwetting. When one or both parents have experienced enuresis/bedwetting that rate climbs to 44% and 77%, respectively.
What can be done to treat enuresis?
Only a small proportion of enuresis/bedwetting is caused by a specific medical condition so in most cases treatment is prompted by concern for the child’s emotional welfare. Punishment is not effective and interferes with treatment.
Waiting - In most cases nighttime enuresis will go away on its own
Alarms - An alarm which sounds upon sensing moisture can help condition the child to awake upon sensing a full bladder
Medication - Desmopressin serves as a synthetic replacement for antidiuretic hormone (ADH), the natural compound responsible for reducing urine production while asleep.
Living with enuresis
Absorbent underwear and adult diapers can reduce enuresis/bedwetting embarrassment and make cleanup easier for caregivers. These products can be especially helpful for children wishing to attend sleepovers and campouts.