Bedwetting
(Nocturnal Enuresis)

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

• What is bedwetting?
• Are there types of bedwetting?
• What is primary bedwetting?
• What is the basic problem in primary bedwetting?
• Is primary bedwetting  due to emotional problems?
• How is primary bedwetting  treated?
• How common is secondary bedwetting?
• What causes secondary bedwetting?
• How is the cause of secondary bedwetting diagnosed?
• What is the treatment for secondary bedwetting?
• What is the outlook (prognosis) for children with bedwetting?
• Bedwetting At A Glance

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.

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