Enuresis

Enuresis
A child may ignore the body's signal of a full bladder in order to engage in a joyous activity, such as playing on a playground.
Classification and external resources
Specialty	Psychiatry, Pediatrics
ICD-10	F98.0, R32
ICD-9-CM	788.30, 307.6
DiseasesDB	4326
Patient UK	Enuresis
MeSH	D004775
[]

Enuresis (from the Ancient Greek ἐνούρησις enoúrēsis) is a repeated inability to control urination. Use of the term is usually limited to describing individuals old enough to be expected to exercise such control. Involuntary urination is also known as urinary incontinence.

Types of enuresis include:

Also,

After age 5, wetting at night—often called bedwetting or sleepwetting—is more common than daytime wetting in boys. Experts do not know what causes nighttime incontinence. Young people who experience nighttime wetting tend to be physically and emotionally normal. Most cases probably result from a mix of factors including slower physical development, an overproduction of urine at night, a lack of ability to recognize bladder filling when asleep, and, in some cases, anxiety. For many, there is a strong family history of bedwetting, suggesting an inherited factor.

Between the ages of 5 and 10, incontinence may be the result of a small bladder capacity, long sleeping periods, and underdevelopment of the body's alarms in the brain that signal a full or emptying bladder. This form of incontinence will fade away as the bladder grows and the natural alarms become operational.

Normally, the body produces a hormone that can slow the making of urine. This hormone is called antidiuretic hormone, or ADH. The body normally produces more ADH during sleep so that the need to urinate is lower. If the body does not produce enough ADH at night, the making of urine may not be slowed down, leading to bladder overfilling. If a child does not sense the bladder filling and awaken to urinate, then wetting will occur.

Experts suggest that anxiety-causing events occurring in the lives of children ages 2 to 4 might lead to incontinence before the child achieves total bladder control. Anxiety experienced after age 4 might lead to wetting after the child has been dry for a period of 6 months or more. Such events include angry parents, unfamiliar social situations, and overwhelming family events such as the birth of a brother or sister.

Incontinence itself is an anxiety-causing event. Strong bladder contractions leading to leakage in the daytime can cause embarrassment and anxiety that lead to wetting at night.

Certain inherited genes appear to contribute to incontinence. In 1995, Danish researchers announced they had found a site on human chromosome 13 that is responsible, at least in part, for nighttime wetting. If both parents were enuretic, 77% of their children are too; if only one parent was enuretic, then 44% of their offspring are also. Experts believe that other, undetermined genes also may be involved in incontinence.

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