Bedwetting is a very common problem. Nighttime bedwetting is called enuresis nocturna and both daytime and nighttime bedwetting is called enuresis diurna. In children over 5 years of age without congenital or acquired central nervous system defects, enuresis nocturna is defined as nocturnal bedwetting. Enuresis nocturna is divided into two as simple and complicated. In the simple type, there is no other symptom other than bedwetting at night. In the complicated type, sudden feeling of tightness during the day, frequent urination, daytime urinary incontinence and chronic constipation may be observed.
Primary enuresis is a condition in which urinary control is never achieved from birth. Secondary enuresis is the onset of urinary incontinence after a dry period of 6 months. Enuresis is defined for children over 5 years of age and its frequency decreases gradually with age. Enuresis is more common in large families with low socioeconomic and educational level. It is usually seen in boys until the age of 10-11 years.
Causes of bedwetting
Simple bedwetting may have one or more causes. Genetic factors, waking disorders, hormonal factors and bladder-related factors are involved. In 97-98% of cases, there is no organic cause. An organic cause can be detected in 2-3% of cases. These include impaired voiding function, urinary tract infection, urethral obstruction, ectopic ureter, sleep apnoea, diabetes, sugar-free diabetes and hyperthyroidism. The incidence of bedwetting is 77% in those with both enuretic parents and 46% in the child if one of the parents is enuretic. The incidence is higher in identical twins.
The main causes of bedwetting can be listed as follows:
- Waking disorders
- Low bladder capacity and excessive bladder contractions
- Increased amount of urine at night
- Urinary tract infection
- Obstruction of the urethra
- Diabetes
- Sugar-free diabetes
- Hyperthyroidism
- Sleep apnoea syndrome
- Psychological reasons
- Genetic causes
- Attention deficit hyperactivity
