Bed wetting
| Nocturnal enuresis | |
|---|---|
| Synonyms | nighttime urinary incontinence, sleepwetting, bedwetting |
| Classification and external resources | |
| ICD-10 | F98.0, R32 |
| ICD-9-CM | 307.6, 788.36 |
| DiseasesDB | 4326 |
| MedlinePlus | 003144 |
| eMedicine | ped/689 |
| MeSH | D053206 |
Nocturnal enuresis, also called bedwetting, is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary (PNE) when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis (SNE) is when a child or adult begins wetting again after having stayed dry.
Most bedwetting is a developmental delay—not an emotional problem or physical illness. Only a small percentage (5% to 10%) of bedwetting cases are caused by specific medical situations. Bedwetting is frequently associated with a family history of the condition.
Treatments range from behavioral-based options such as bedwetting alarms, to medication such as hormone replacement, and even surgery such as urethral enlargement. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Bedwetting children and adults can suffer emotional stress or psychological injury if they feel shamed by the condition. Treatment guidelines recommend that the physician counsel the parents, warning about psychological damage caused by pressure, shaming, or punishment for a condition children cannot control.
Bedwetting is the most common childhood complaint. Most girls stay dry by age six and most boys stay dry by age seven. By ten years old, 95% of children are dry at night. Studies place adult bedwetting rates at between 0.5% and 2.3%.
The medical name for bedwetting is nocturnal enuresis. The condition is divided into 2 types: primary nocturnal enuresis (PNE) and secondary nocturnal enuresis.
Primary nocturnal enuresis (PNE) is the most common form of bedwetting. Bedwetting counts as a disorder once a child is old enough to stay dry, but continues either to average at least two wet nights a week with no long periods of dryness or to not sleep dry without being taken to the toilet by another person.
New studies show that antipsychotic drugs can have a side effect of triggering enuresis.
It has been shown that diet impacts enuresis in children. Constipation and Impacted bowels from poor diet can back up stool in the colon, putting undue pressure on the bladder creating loss of bladder control.
Medical guidelines vary on when a child is old enough to stay dry. Common medical definitions allow doctors to diagnose PNE beginning at between 4 and 5 years old. This type of classification is frequently used by insurance companies. It defines PNE as, "persistent bedwetting in the absence of any urologic, medical or neurological anomaly in a child beyond the age when over 75% of children are normally dry."
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