Urinary Incontinence (Enuresis) in Children

What is enuresis in children?

Urinary incontinence (enuresis) is
the loss of bladder control. In children younger than age 3, it’s normal to not have
full bladder control. As children get older, they become more able to control their
bladder. Wetting is called enuresis when it happens in a child who is old enough to
control his or her bladder. Enuresis can happen during the day or at night. It can be a
frustrating condition. But it’s important to be patient and remember that it’s not your
child’s fault. A child does not have control over enuresis. And there are many ways to
treat it and help your child.

There are 4 types of enuresis. A
child may have 1 or more of these types:

  • Nighttime (nocturnal) enuresis. This
    means wetting during the night. It’s often called bedwetting. It’s the most common
    type of enuresis.
  • Daytime (diurnal) enuresis. This is
    wetting during the day.
  • Primary enuresis. This happens when a
    child has not fully mastered toilet training.
  • Secondary enuresis. This is when a
    child has a period of dryness, but then returns to having periods of wetting.

What causes enuresis in a child?

Enuresis has many possible causes.
The cause of nighttime enuresis often is not known. But possible causes and risk factors
may include 1 or more of these:

  • Anxiety
  • Attention deficit/hyperactivity
    disorder (ADHD)
  • Certain genes
  • Constipation that puts pressure on the
    bladder
  • Delayed bladder development
  • Diabetes
  • Not enough antidiuretic hormone (ADH)
    in the body during sleep
  • Obstructive sleep apnea
  • Overactive bladder
  • Slower physical development
  • Small bladder
  • Structural problems in the urinary
    tract
  • Trouble feeling that the bladder is
    full while asleep
  • Urinary tract infection
  • Very deep sleep

Daytime enuresis may be caused by:

  • Anxiety
  • Caffeine
  • Constipation that puts pressure on the
    bladder
  • Stopping urine stream before finishing (dysfunctional
    voiding)
  • Not going to the bathroom often
    enough
  • Not urinating enough when going
  • Overactive bladder
  • Small bladder
  • Structural problems in the urinary
    tract
  • Urinary tract infection
  • Keeping legs too close together traps urine in the vagina and
    urine leaks out (vaginal voiding)

Which children are at risk for enuresis?

A child is more at risk for enuresis if he or she:

  • Is constipated
  • Doesn’t have regular bathroom habits
  • Has physical development problems
  • Has anxiety

What are the symptoms of enuresis in a child?

Symptoms can be a bit different for
each child. The main symptom is when a child age 5 or older wets their bed or their
clothes 2 times a week or more, for at least 3 months. But 1 in 10 children age 7, 1 in
20 children age 10, and 1 in 100 children older than 15 still have at least one episode
of nighttime enuresis.

The symptoms of enuresis can seem
like other health conditions. Have your child see his or her healthcare provider for a
diagnosis.

How is enuresis diagnosed in a child?

Many children may have enuresis from time to time. It can take some children longer than others to learn to control their bladder. Girls often have bladder control before boys. Because of this, enuresis is diagnosed in girls earlier than in boys. Girls may be diagnosed as young as age 5. Boys are not diagnosed until at least age 6.

Your child’s healthcare provider
will ask about your child’s health history. Tell the healthcare provider:

  • If other family members have had enuresis
  • How often your child urinates during the day
  • How much your child drinks in the evening
  • If your child has symptoms such as pain or burning when urinating
  • If the urine is dark or cloudy or has blood in it
  • If your child is constipated
  • If your child has had recent stress in his or her life

The healthcare provider may give your child a physical exam. Your child may also need tests, such as urine tests or blood tests. These are done to look for a health problem, such as an infection or diabetes.