Bed Wetting 101

Bed wetting is a common problem in children all over the world. However, the disorder is not life threatening and most children over come the problem with time. Bed wetting is not considered a problem until the child reaches the age of 5. To make a diagnosis of nocturnal enuresis or bed wetting, the child must have reached the age of 5/6 and have at least two or more bed wetting episodes every 4 weeks.

While the exact number of individuals with this problem is not known, it is estimated that close to 20-25 percent of children wet the bed at least once a month. As the child matures, the numbers do decline.

By the age of 12, about 8-10 percent of boys remain enuretic and only about 4% of girls have the same problem. After puberty, it is estimated that about 1-3 percent of teenagers or young adults continue to wet the bed.

Despite a long history, the cause of nocturnal enuresis remains elusive and is believed to be multifactorial. While no definite genetic link has been identified, the incidence is much greater in families where one or both parents had the problem. Factors such as stress, family life, social background or economic situation have not found to have any association with nocturnal enuresis.

In the years past, it was widely thought that psychological trauma was the cause of this disorder. Today, it is believed that the psychological problems are as a result of bed wetting. So far not a single study has shown that children with bed wetting have a higher incidence of psychological problems compared to the normal population. Bedwetting is not an act of defiance, rebellion nor is it linked to any type of personality disorder.

While primary enuresis may occur without a cause, there are secondary causes of nocturnal enuresis. These include trauma to the spinal cord, congenital spinal cord deformities, posterior urethral valves in boys and ectopic (abnormal origin or location) ureters in girls. Sometimes children who have severe constipation may also present with bed wetting.

Investigations for bed wetting depend on the physical findings and laboratory work up. If the physical exam is unremarkable and the urinalysis is normal, then no further work up is required. Individuals who are found to have urinary tract infection or physical abnormalities of the spinal cord, usually have to undergo more testing.

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