Bedwetting

Bedwetting
Other names	Nocturnal enuresis
Specialty	Pediatrics, Urology
Symptoms	Involuntary urination during sleep
Usual onset	Typically before age 5-7
Duration	Can persist into adolescence
Types	Primary, Secondary
Causes	Genetic factors, Sleep disorders, Urinary tract infections, Diabetes, small bladder capacity
Diagnostic method	Based on symptoms, excluding other conditions
Differential diagnosis	Diabetes, Urinary tract infection, Sleep apnea
Prevention	Limiting fluids before bedtime, regular urination schedule
Treatment	Behavioral therapy, moisture alarms, medications
Medication	Desmopressin, anticholinergics
Prognosis	Often resolves with age
Frequency	Common in children

Bedwetting, also known as nocturnal enuresis, is a common condition where an individual, usually a child, involuntarily urinates during sleep. It is considered a normal part of childhood development up to a certain age, typically around 5-7 years. Beyond this age, if bedwetting continues, it may be a concern and require further investigation.

Classification

Bedwetting can be classified into two types:

• Primary nocturnal enuresis occurs when a child has not yet stayed dry on a regular basis.
• Secondary nocturnal enuresis begins after the child has been dry at night for a significant period, typically more than six months, and then begins to wet the bed again.

Causes

The causes of bedwetting are often multifactorial and can include:

• Genetics: A family history of bedwetting can increase the likelihood of the condition.
• Sleep disorders: Issues such as sleep apnea can disrupt the sleep cycle and lead to bedwetting.
• Urinary tract infections: These can cause an increased urgency to urinate, which can lead to nighttime accidents.
• Diabetes: High blood sugar levels can lead to increased urine production and bedwetting.
• Small bladder capacity: Some children have a smaller than average bladder, which can lead to difficulties holding urine throughout the night.

Diagnosis

Diagnosis of bedwetting is primarily based on the medical history and symptoms presented by the patient. It is important to rule out other possible conditions such as diabetes or a urinary tract infection. A detailed history from the parents regarding the onset and frequency of bedwetting episodes is crucial.

Treatment

Treatment options for bedwetting can vary based on the age of the child and the underlying cause of the bedwetting. Common treatments include:

• Behavioral therapy: Techniques such as positive reinforcement and bladder training exercises.
• Moisture alarms: These devices wake the child at the first sign of wetness, helping them to associate the sensation of a full bladder with waking up.
• Medications: Drugs such as desmopressin or anticholinergics may be used in some cases to manage symptoms.

Prognosis

Most children outgrow bedwetting naturally as they age. The prognosis is generally good, with many children ceasing to wet the bed by adolescence.

See also

• Pediatric urology
• Child development
• Sleep in children