Enuresis Basics

Commonly called bedwetting, enuresis is characterized by urinary incontinence in children 5 years old and up, whether it occurs at night or during the day. Our guide outlines the symptoms of enuresis and explores how the disorder is diagnosed and treated in children.

Enuresis: What Is It?

Enuresis is a disorder characterized by a child’s repeated voiding of urine into a his bed or clothing, night or day. It’s diagnosed only in children who are 5 or older. The incontinence is usually involuntary, but sometimes voluntary.  Some children with enuresis may not notice that they need to go to the bathroom.  Others may realize that they need to urinate but then become distracted and forget until it is too late.  While most children outgrow enuresis by adolescence, the disorder can cause them great embarrassment and may create a strain on the whole family.

Enuresis: What to Look For

It is common for young children to have poor bladder control.  But if a child is 5 or older and experiences urinary incontinence on a regular basis, especially if this behavior is new, he may have enuresis. Some children are incontinent only at night, others only during the day, and some both times. Children with the disorder are frequently very heavy sleepers and may not notice that they are wetting the bed. Some kids describe themselves as too tired to go to the bathroom or too involved in play or other activities to stop.

Enuresis: Risk Factors

Eneuresis has been shown to run in families. The risk of developing eneuresis is three times greater if a child’s mother had the disorder, and 10 times greater if the father had it. Other risk factors include delayed or lax toilet training and stress. Incontinence at night is more common among boys, and incontinence during the day is more common in girls.

Enuresis: Diagnosis

Enuresis is diagnosed in children who are at least 5 years old and experience urinary incontinence, whether during the day or at night, involuntary or intentional. It’s considered enuresis if it occurs at least twice a week for at least 3 months, or if it is creating problems for the child in school or social environments. Before a diagnosis is made a clinician will perform a physical exam to make sure that the child is not suffering from a urinary tract infection, diabetes, or another medical condition that produces similar symptoms.

Enuresis: Treatment

Most cases of enuresis are treated through behavioral therapy, although in some cases medication may be prescribed.

Psychotherapeutic: An experienced clinician can work with families to craft a behavioral approach. There are several options, among them moisture alarms—sensors that detect moisture and will wake a child whenever he begins to wet the bed—that have proven extremely effective in treating enuresis, though they may take several weeks. Other options may include limiting liquid and caffeine intake at night, encouraging frequent urination, and rewarding kids for each night without bedwetting.

Pharmacological: There are some medical options for treating enuresis, but they only work in the short-term; when the child stops taking the medicine he will resume wetting his bed. Desmopressin, which can be taken in a pill or nasal-spray form, causes less urine to be produced at night. If a child has a small bladder, another option might be Ditropan or Levinsin, which increases bladder capacity and decreases bladder contractions.