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Bedwetting

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Definition:

Bedwetting is involuntary urination in children over 5 to 6 years old. It may occur at any time of the day or night. This article focuses on nighttime bedwetting.

See also: Incontinence

Alternative Names:

Enuresis

Causes, incidence, and risk factors:

Children develop complete control over their bladders at different ages. Nighttime dryness is usually the last stage of toilet learning. When children wet the bed more than twice per month after age 5 or 6, it is called bedwetting or nocturnal enuresis.

Children who were dry for at least 6 months and then started wetting again have secondary enuresis. There are many reasons that children wet the bed after being fully toilet trained. It might be physical, emotional, or just a change in sleep.

Children who have never been consistently dry at night have primary enuresis. This usually occurs when the body makes more urine overnight than the bladder can hold and the child does not wake up when the bladder is full. The child's brain has not learned to respond to the signal that the bladder is full. It is not the child's or the parent's fault.

Physical causes are rare, but may include lower spinal cord lesions , congenital malformations of the genitourinary tract, infections of the urinary tract, or diabetes .

Bedwetting runs strongly in families. More than 5 million children in the U.S. wet the bed.

About 9% of boys and 6% of girls still wet the bed at age 7. The numbers drop slightly by age 10. Although the problem goes away over time, many children and even a small number of adults continue to have bedwetting episodes.

References:

Blum NJ. Nocturnal enuresis: behavioral treatments. Urol Clin North Am . 2004; 31(3):499-507.

Fritz G. Practice parameter for the assessment and treatment of children and adolescents with enuresis. J Am Acad Child Adolesc Psychiatry . 2004; 43(12):1540-1550.

Lawless MR, McElderry DH. Nocturnal enuresis: current concepts. Pediatr Rev . 2001;(12):399-407.

Mammen AA. Nocturnal enuresis: medical management. Urol Clin North Am . 2004; 31(3):491-498.

Robson WLM, Leung AKC, Van Howe R. Primary and secondary nocturnal enuresis: similarities in presentation. Pediatrics . 2005; 115(4):956-959.

• Review Date: 5/1/2007
• Reviewed By: Rachel A. Lewis, MD, FAAP, Columbia University Pediatric Faculty Practice, New York, NY. Review provided by VeriMed Healthcare Network.

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