Cystitis is a common cause of enuresis and an aggravating factor associated with other causes; cystitis associated with enuresis may present at any age. Cystitis causes uninhibited detrusor contractions that can lead to episodes of daytime and nighttime wetting.
Primary enuresis is that which occurs in a child who has not been dry for at least 6 months, whereas secondary enuresis is the one that has an onset after a period of nocturnal dryness of at least 6 months.
Enuresis is the medical term for involuntary urination or “wetting.” Other words for this problem include incontinence, voiding problems, or urinary accidents.
Desmopressin acetate is the preferred medication for treating children with enuresis. A Cochrane review of 47 randomized trials concluded that desmopressin therapy reduces bedwetting; children treated with desmopressin had an average of 1.3 fewer wet nights per week.
Bedwetting, or nocturnal enuresis, is involuntary urination while asleep after the age at which staying dry at night can be expected. This should not be confused with nocturia, which describes frequent urination – in other words, the need wake up one or more times at night to void.
Adults with nocturnal enuresis usually have an underlying medical or psychological condition that leads to bedwetting. Bedwetting occurs more often among boys or children assigned male at birth (AMAB). You may be more at risk of nocturnal enuresis if you have severe emotional trauma or stress.
And although stress can indirectly affect a child's bedwetting, most experts believe it isn't the reason a child starts wetting the bed. There's just “no major association between anxiety, stress, and bedwetting,” says Anthony Atala, MD, chair of urology at the Wake Forest University School of Medicine.
Stress and anxiety in and of themselves will not cause a child who never wet the bed to start nighttime wetting. However, stress can contribute indirectly to nighttime wetting. Emotional and psychological stress can cause a child to behave or act differently, which can lead to nighttime wetting.
Bedwetting and Bladder Issues
“Every child is different. But as a general rule, if your son or daughter is not dry through the night by age six, you may want to have a consultation with a pediatric urologist,” Dr. Hannick says.
Bedwetting is not considered abnormal until after five years of age. That being said, there isn't a specific age when you should become overly concerned about the issue. The rule of thumb is that you should seek treatment when your child starts to worry about wetting the bed or you start to worry about the issue.
Someone with primary nocturnal enuresis has wet the bed since they were a baby. This is the most common type of enuresis. Secondary enuresis is a condition that develops at least 6 months — or even several years — after a person has learned to control their bladder.
Psychological factors are clearly contributory in a minority of children with enuresis. These children have experienced a stress such as parental conflict, trauma, abuse, or hospitalization. In these few cases the wetting is seen as a regressive symptoms in response to the stress.
This can lead to isolation and depression. Incontinence, when left untreated and inadequately managed, can lead to rashes and other skin disorders. If overflow incontinence is not treated, it can lead to urinary tract infection. If severe enough, urinary retention can be a medical emergency.
Nocturnal enuresis or bedwetting is the involuntary release of urine during sleep. Bedwetting can be a symptom of bladder control problems like incontinence or overactive bladder or more severe structural issues, like an enlarged prostate or bladder cancer.
Bedwetting can frequently occur in children with ADHD. The medical term for bedwetting is enuresis. Research has found that around 28–32% of people with ADHD may also have enuresis. Another study found that around 40% of children with ADHD may also have enuresis.
Conversely, children who are depressed sometimes show up with symptoms common in childhood like enuresis or bed-wetting -- that's a common symptom of depression in young people.
Stress and anxiety.
Ongoing stress or anxiety about a situation you are going through may trigger adult bedwetting, which may last long after your stressful problem is over.
What are the symptoms of post-traumatic stress disorder in children? These are some of the most common symptoms of PTSD in children: Sleep disturbances including fear of sleep, nightmares or bedwetting.
In recent years, researchers have suggested that enuresis usually took place in the N2 phase [a phase in non-rapid eye movement (NREM)] and “deep sleep phase” (12, 17, 19). Other studies point out that enuresis may occur during the sleep phase transition period (N3 → N2 or N2 → N1).
What is Daytime Wetting (Diurnal Enuresis)? Daytime wetting is when a child who is toilet trained has wetting accidents during the day.
Desmopressin Acetate (DDAVP)
DDAVP is a drug to treat children with bed-wetting. Although DDAVP does not cure the condition, it does help treat the symptoms while the child is on the drug. Numerous studies report reduction in the number of wet nights.
The two drugs approved by the FDA specifically for bed-wetting are DDAVP and Tofranil. Other medications that are sometimes used to treat bed-wetting include Ditropan and Levsin. Drug therapy does not work for everyone, and these medications can have significant side effects.