What is enuresis?

Enuresis is the medical term for bedwetting. It is a condition where a child involuntarily passes urine during sleep. Most children stop bedwetting after the age of 5 or 6 years but studies have also shown that between 10 and 15% of all children in the ages 5-12 years continue to wet their beds although they have no underlying kidney disorder. A study in Malaysia found that about 6.2% of 7-12 years old are still bedwetting.

What is the cause of enuresis?

Bedwetting often runs in family.

Bedwetting can be caused by :

• Smaller bladder capacity.
• Sleep disorder; most bedwetters are said to be deep sleepers although there is no conclusive evidence of this.
• Lower production of a hormone called vasopressin during sleep. Vasopressin is important for reducing urine production at night.

Types of bedwetting

• Bedwetting only at night in a otherwise very well child (primary nocturnal enuresis).
• Bedwetting at night with daytime wetting (incontinence) – this needs further evaluation by a doctor for the underlying cause.
• Other underlying disorder that may cause bedwetting (secondary enuresis) are urinary tract infection, spinal cord problems, bladder abnormalities and metabolic problems like diabetes mellitus. Usually these conditions will present with other symptoms and signs besides bedwetting

Does bedwetting need investigation?

• Not necessary if the history is bedwetting at night only (primary nocturnal enuresis) with no other symptoms and signs of underlying abnormalities. Child is otherwise very well.

What are potential complications?

• May cause low self-esteem in the child and low self-esteem by itself can be a risk factor for psychiatric and other social disorders.
• Stress in the family

Treatment modalities

• Behavioral modification. e.g. a system to reward your child for dry nights.
• Bedwetting alarm which is activated to wake your child up when he wets the bed (not widely available in Malaysia.
• Medication to help your child stay dry; ask your doctor about it.
• Remember : enuresis gets better with age.

Other helpful measures

• Do not blame your child; it is not his or her fault. Talk about it openly with your child.
• Drink less in the evening / night.
• Wake or lift your child later at night for him to pee – may prevent wet beds but not cure enuresis.
• Use waterproof mattress cover / quilt.
• Room deodorant.
• Shower in the morning before going to school.