Alternate Names : Bedwetting, Bladder Incontinence, Loss of Bladder Control, Uncontrollable Urination
Enuresis is the intentional or involuntary voiding of urine into clothes or
other inappropriate places by a child who is at least 5 years old. To meet the
criteria for enuresis, the involuntary or intentional voiding must occur at least
twice a week or more for three months.
What is going on in the body?
In a child with enuresis, there is no physical disorder. Primary
enuresis occurs when bladder control has never been achieved. Secondary
enuresis occurs when bladder control has been achieved for at least one year
but has then been lost. Enuresis may occur only at night, only in the day, or
during both day and night.
What are the causes and risks of the condition?
Causes of enuresis are usually psychosocial and physiologic. Children with
enuresis often have other developmental delays. They tend to have smaller
bladders and a higher likelihood of a learning disability. A link between enuresis and a
sleep disorder may be
involved, but there is no clear proof of this.
Genetics may also play a role in the development of enuresis. Having one
enuretic parent increases the chance of the child having enuresis by 45%. If both parents are enuretic, the risk increases to 75%.
twice as many males as females are enuretic.
Some cases of enuresis are related to
toilet training that was begun too early or was very forcible.
Enuresis may be a temporary regression or an adjustment problem. Parents who
are very controlling and quick to find fault may also trigger problems with bladder
Medical causes of enuresis include the following:
lower urinary tract obstruction
neurogenic bladder, which is a bladder with impaired nerve function
which is a breathing disorder that occurs during sleep