Enuresis

Alternative names:

bed wetting

Definition:

Involuntary urination in children over 4 to 5 years old. It usually occurs at night. (See also incontinence.)

Causes, incidence, and risk factors:

Children vary in the age at which they are physically ready to have complete control over their bladders. Many children are not ready for toilet training before the age of 3. Enuresis usually does not indicate an emotional or physical problem. It is more than twice as common among boys as girls. Causes may be due to a maturational delay in the development of bladder musculature and its ability to withstand the pressure of a large urine volume. It may also be related to toilet training that occurred too early or was too coercive. It may also be a symptom of temporary regression, a response to a new situation, to parents who are too controlling or critical, or as a problem of adjustment. Physical causes are rare, but may include lower spinal cord lesions, congenital malformations of the genitourinary tract, infections of the urinary tract, or diabetes. Risk factors are related to the causes. At age 5 about 7 in 100 boys and 3 in one hundred girls have bed wetting problems. The percentages decrease rapidly after age 5 years. Risk factors include a family history of bed wetting.