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Bedwetting
Definition:
Bedwetting is involuntary urination in children over 5 to 6 years old. It usually occurs at night. (See also incontinence.) Alternative Names: Enuresis
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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, we call it bedwetting or enuresis. Children who were dry for at least 6 months and then started wetting again have secondary enuresis. The key here is to find what changed. It might be physical, emotional, or just a change in sleep. When the child has never been dry, that is called primary enuresis. The cause is usually making more urine overnight than the bladder can hold and being a deep sleeper. 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. At age 5, more than 7% of` boys and 3% of girls wet. At age 10, 3% and 2% still do. References:
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. Blum NJ. Nocturnal enuresis: behavioral treatments. Urol Clin North Am. 2004; 31(3): 499-507. Mammen AA. Nocturnal enuresis: medical management. Urol Clin North Am. 2004; 31(3): 491-498.
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