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Enuresis

Enuresis is the inability to control urination - involuntary urination - when a child would normally be expected to be able to control their bladder.

Bedwetting is a type of enuresis, called nocturnal enuresis.

What are the symptoms of enuresis?

The main symptoms of enuresis are:

  • Repeated bedwetting at night
  • Wetting in clothes during the day.

 

What’s the impact of enuresis?

  • Worry
  • Embarrassment
  • Anxiety
  • Loss of self-esteem
  • Avoiding sleepovers, school trips.

 

What are the types of enuresis?

The main types of enuresis are:

  • Primary enuresis - still wetting by age 6
  • Secondary enuresis - starts wetting after being dry for some months.

 

What causes enuresis?

Causes of daytime enuresis can include:

  • Physical causes
  • Emotional causes
  • Unwillingness to use certain toilets, such as at school
  • Forgetfulness
  • Hurrying, not completely emptying bladder
  • Constipation
  • Urinary tract infection.

Causes of night-time enuresis include:

  • Late development, lacking the instinct to wake or get to the toilet when bladder is full
  • Tiredness
  • Illness
  • Drinking too much before bedtime
  • Emotional causes
  • Constipation
  • Urinary tract infection
  • Lacking vasopressin hormone
  • Family history of bedwetting.

 

How common is enuresis?

Wetting during the day affects around 1 in 75 over-5s. The condition affects girls more than boys.

Bedwetting at night by comparison affects around 1 in 40 children aged 7 and a half. This is more common in boys than girls.

Daytime wetting can happen alongside night-time bedwetting or separately.

How is enuresis diagnosed?

A diagnosis will be based on:

  • Symptoms, pattern of wetting
  • Medical history, other health conditions
  • Any emotional causes
  • Any physical causes
  • Testing for urinary tract infections
  • Asking about constipation
  • Fluid drinking habits
  • Diet habits
  • Checking for medication side-effects
  • Any developmental or behavioural issues.

 

How is enuresis treated?

Treatment will depend on individual circumstances and causes, and may include:

  • Treating any urinary tract infections
  • Advice on avoiding constipation
  • Behaviour therapy
  • Night-time wetting alarms
  • Bladder training to adapt to longer gaps between toilet visits
  • Rewards for good bladder control
  • Medication.

 

What is the outlook for children with enuresis?

In most cases, children outgrow enuresis, or can become dry with support or treatment.

Can enuresis be prevented?

It is not possible to prevent all cases of enuresis - especially if there are physical causes.

Being positive and patient with a child during toilet training may help prevent the development of negative attitudes about using the toilet.

WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on August 23, 2016

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