Bedwetting

Bedwetting (nocturnal enuresis) is involuntary urination during sleep in children over five.

Overview of Bedwetting

Bedwetting, medically known as nocturnal enuresis, is involuntary urination during sleep in children over the age of five. It is a common condition, often seen in young children, and generally resolves as they grow older. Bedwetting can be classified into primary (when a child has never been dry at night) and secondary (when a child begins wetting the bed after being dry for at least six months).

Historically, the social stigma associated with bedwetting has led to a variety of punitive and misguided treatments. It wasn’t until the 20th century that a more comprehensive understanding of the physiological and psychological aspects of nocturnal enuresis emerged, leading to the development of more effective and empathetic interventions.

Causes

Genetic Factors: A family history of bedwetting.

Overactive Bladder: Smaller functional bladder capacity with increased sensitivity to bladder fullness.

Sleep Disorders: Deep sleep can make it difficult for a child to wake up to urinate.

Stress and Anxiety: Emotional stress or changes in the child’s environment.

Medical Conditions: Urinary tract infections, dysfunctional voiding, and/or constipation.

Hormonal Factors: Insufficient production of antidiuretic hormone (ADH) which can allow increased urine production at night.

Risk Factors

  • Constipation.
  • Male gender (boys are more likely to wet the bed than girls).
  • Developmental delays that can affect toilet training.

Complications

Emotional Impact: Can cause embarrassment, anxiety, and low self-esteem.

Social Impact: May limit social activities like sleepovers or camping.

Skin Problems: Rashes or irritation due to prolonged exposure to urine.

Infections: Urinary tract infections may be more likely with altered perineal flora.

Prevention

  • Limit fluid intake in the evening.
  • Encourage regular bathroom visits during the day and right before bedtime.
  • Establish a consistent bedtime routine.
  • Encourage bowel movements right before bedtime every night.

Symptoms

  • Involuntary urination during sleep, at least twice a week for at least three months
  • If the child begins bedwetting after a period of dryness
  • Difficulty waking from sleep
  • Wetting during daytime or nighttime, with nighttime bedwetting being more common
  • If the bedwetting is accompanied by other symptoms such as pain during urination, excessive thirst, or snoring

When to see a doctor

  • If bedwetting continues beyond the age of five
  • Presence of urinary tract infections
  • Severe emotional distress
  • Associated bowel problems

Schedule an appointment

Connect with our dedicated team to provide your child with the highest quality care for all their surgical and urological needs.