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March 16, 2010
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Bedwetting
(Nocturnal Enuresis)

Medical Author: David Perlstein, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What is bedwetting?

Bedwetting, also called nocturnal enuresis, is the involuntary passage of urine (urinary incontinence) while asleep. Inherent in the definition of bedwetting is satisfactory bladder control while the person is awake.

Are there types of bedwetting?

Two types of bedwetting occur:

  1. Primary enuresis -- bedwetting since infancy; and


  2. Secondary enuresis -- wetting developed after being continually dry for a minimum of six months.

What is primary bedwetting?

Primary bedwetting is generally viewed as a delay in maturation of the nervous system. At 5 years of age, approximately 20% of children wet the bed at least once a month with about 5% of males and 1% of females wetting nightly. By 6 years of age, only about 10% of children are bedwetters -- the large majority being boys. The percentage of all children who are bedwetters continues to diminish by 50% each year after 5 years of age. Family history plays a big roll in predicting primary bedwetting. If one parent was a bedwetter, the offspring have a 45% chance of a developing primary enuresis as well.

What is the basic problem in primary bedwetting?

The fundamental problem faced by children with primary bedwetting rests in the inability while asleep to recognize neurologic messages sent by the full bladder to the sleep arousal centers of the brain. In addition, bladder capacity is often smaller in bedwetting children than in their peers.

Is primary bedwetting due to emotional problems?

Parents sometimes believe that their child's primary bedwetting is emotional. No medical or scientific literature exists to support this impression.



Next: How is primary bedwetting  treated? »

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Bedwetting

What Are Elimination Disorders?

Elimination disorders occur in children who have problems going to the bathroom—both defecating and urinating. Although it is not uncommon for young children to have occasional "accidents," there may be a problem if this behavior occurs repeatedly for longer than 3 months, particularly in children older than 5 years.

There are two types of elimination disorders, encopresis and enuresis.

  • Encopresis is the repeated passing of feces into places other than the toilet, such as in underwear or on the floor. This behavior may or may not be done on purpose.


  • Enuresis is the repeated passing of urine in places other than the toilet. Enuresis that occurs at night, or bed-wetting, is the most common type of elimination disorder. As with encopresis, this behavior may or may not be done on purpose.

What Are the Symptoms of Encopresis?

...

Read the Encopresis article »











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