Nocturnal enuresis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Nocturnal enuresis
Synonyms	Bedwetting
Pronounce	N/A
Specialty	N/A
Symptoms	Involuntary urination during sleep
Complications	Emotional distress, social stigma
Onset	Typically in children
Duration	Can persist into adulthood
Types	N/A
Causes	Genetics, deep sleep, hormonal imbalance, bladder dysfunction
Risks	Family history, stress, constipation
Diagnosis	Based on medical history and physical examination
Differential diagnosis	Diabetes mellitus, urinary tract infection, seizure disorder
Prevention	Limiting fluid intake before bed, bladder training
Treatment	Behavioral therapy, alarm therapy, medication
Medication	Desmopressin, anticholinergics
Prognosis	N/A
Frequency	Common in children, less common in adults
Deaths	N/A

Nocturnal enuresis, also known as bedwetting, is the involuntary urination during sleep after the age at which bladder control usually begins. Bedwetting is a common childhood issue, and it can also affect adults, resulting in emotional stress. Complications may include urinary tract infections.

Underjams

Signs and symptoms

The primary symptom of nocturnal enuresis is involuntary urination during sleep. This can occur at any time during the night and may be accompanied by:

• Increased frequency of urination during the day
• Urgency to urinate
• Straining or discomfort while urinating

Causes

There are various possible causes of nocturnal enuresis, including:

• Genetic factors
• Delayed maturation of the nervous system
• Overactive bladder muscles
• Small bladder capacity
• Hormonal imbalances affecting urine production
• Sleep disorders, such as sleep apnea
• Psychological factors, such as stress or anxiety
• Constipation

Diagnosis

Diagnosis of nocturnal enuresis is primarily based on the patient's medical history and a physical examination. Additional tests may be performed to rule out underlying medical conditions or to identify potential contributing factors, such as:

• Urinalysis to check for infections or other abnormalities
• Blood tests to assess kidney function and hormone levels
• Imaging studies, such as ultrasound or X-rays, to evaluate the urinary system

Treatment

Treatment for nocturnal enuresis depends on the underlying cause, the age of the patient, and the severity of the problem. Options may include:

• Behavioral modifications, such as setting a regular bedtime routine, limiting fluid intake before bedtime, and using a bedwetting alarm
• Medications, such as desmopressin (a synthetic form of the antidiuretic hormone) or anticholinergic drugs to reduce bladder contractions
• Bladder training exercises to increase bladder capacity and improve control
• Counseling or therapy to address psychological factors, such as stress or anxiety
• Treatment of underlying medical conditions, such as constipation or sleep apnea

Prognosis

In most cases, nocturnal enuresis resolves on its own as a child grows and develops. With appropriate treatment and support, the majority of children and adults affected by bedwetting can achieve improved bladder control and a reduction in symptoms.

Epidemiology

Nocturnal enuresis is the most common childhood complaint, affecting approximately 5-10% of children aged 7 years and 1-3% of adolescents. The condition is more common in boys than in girls and tends to decrease in prevalence with age.

See also

• Urinary incontinence
• Overactive bladder
• Sleep disorders

External links

• American Urological Association: Bedwetting
• National Sleep Foundation: Bedwetting

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