Bedwetting or Nocturnal Enuresis

Nocturnal enuresis is defined as the involuntary passing of urine during sleep. Sometimes this condition is referred to as bedwetting or sleep wetting. The most important fact about this disorder is that involuntary urination occurs after an age at which voluntary bladder control is expected to be fully developed. Control of the bladder and the physiological process of urination is usually acquired by the age of 2-3 in most children. At around this age, most children are starting to develop a large bladder capacity. The prostate gland also enlarges and plays a crucial control in controlling the urethra.

Bedwetting is usually seen after the age of 3 and can continue for many years.

Initially there may be some signs that the child may be prone to nocturnal enuresis. The child may have sudden urgency to urinate, unable to hold the bladder after drinking liquids or may have frequent episodes of inappropriate voluntary urination. The condition is common in pediatric practice and often associated with a number of major psychological and social issues surrounding the child.

Bedwetting is quite widespread and the reported numbers are misleading. The reason for the errors in reporting is that many individuals or families do not report this condition to the health care worker because of embarrassment. The disorder does vary in severity and can be quite disabling for the child. Even though socially unacceptable, the disorder is not life threatening nor does it have cause any physical health problems.

Even though bedwetting has a long history and is well known in medical practice, the majority of health care workers have little training in both how to approach the patient or talk to the family. The family and the child also are quite embarrassed about the disorder and would like help but do not know how to best approach the health care worker.

There is a lot of literature on nocturnal enuresis and with the advent of the internet; there is a plethora of information available online for the consumer. However, the cause of bedwetting still remains controversial and its management is empirical.

The treatment of nocturnal enuresis is somewhat complex and requires several approaches. Sometimes the disorder may have an underlying causes and work up is required depending on how the child presents. Besides the child, the family, parents have to be involved in the care treatment plans. In almost all cases, a cooperative approach with the family and child produces the best results.

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