Enuresis

Children with enuresis (bedwetting) often have daytime symptoms of urgency, urinary frequency and daytime urine accidents.  Medication is often helpful as are voiding schedules and techniques. Behavioral modification techniques are also helpful.

Some children sleep soundly and do not wake when they feel the urge to urinate. For many children genetics and gender play a role. Boys are twice as likely to wet the bed as girls and if a mother had bedwetting when she was a child there is a 3-4 times higher likelihood of bedwetting in her offspring.

Children with primary enuresis have never been consistently dry at night. These children make more urine during the night than their bladder can hold and do not wake during the night to urinate. Physical causes are rare and include defects in the genitourinary tract or spinal cord problems. Each child with primary enuresis must be carefully evaluated for these rare conditions.

Secondary enuresis, also called temporary enuresis, is often seen in children with recent life stress issues. In secondary enuresis children who had been previously dry for many months begin to bed wet.  These causes include physical, emotional or sleep related issues.

The most common primary and secondary cause of enuresis is constipation. Over a period of days to weeks or months a child develops a pattern of stool retention. This causes the child’s rectum to become a reservoir for stool and pushes on the bladder causing the bladder to become overactive and have “less room” to store urine. This results in frequent urination and night time accidents. A comprehensive history and physical examination are essential to this diagnosis as is an effective and comprehensive treatment protocol that addresses all physical, dietary and social-emotional issues.

Uncommon secondary issues include diabetes and infection.

Your pediatrician will work with you to identify and assess the causes and any family dynamics issues related to the enuresis. A collaborative treatment program focused on you and your child’s needs, including financial and medication concerns, must be developed and supported so you can make the right decision about a treatment program for your child.