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Understanding Childhood Bedwetting

Enuresis, or bedwetting, is the involuntary passage of urine in children beyond the typical age of bladder control development. It is more common in boys and tends to run in families. It can be primary, occurring in children who have never been dry, or secondary, developing after a period of continence. Most cases are nocturnal only. Causes include disorders of sleep arousal, small bladder capacity, overactive bladder, cystitis, constipation, and psychological factors. Treatment involves ruling out physical causes with exams, evaluating bladder function, addressing any psychological issues, restricting fluids before bed, and scheduled awakenings to void.

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95 views3 pages

Understanding Childhood Bedwetting

Enuresis, or bedwetting, is the involuntary passage of urine in children beyond the typical age of bladder control development. It is more common in boys and tends to run in families. It can be primary, occurring in children who have never been dry, or secondary, developing after a period of continence. Most cases are nocturnal only. Causes include disorders of sleep arousal, small bladder capacity, overactive bladder, cystitis, constipation, and psychological factors. Treatment involves ruling out physical causes with exams, evaluating bladder function, addressing any psychological issues, restricting fluids before bed, and scheduled awakenings to void.

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Princess Angel Lucanas
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ENURESIS (BEDWETTING)

I. Definition
- Involuntary passage of urine in children who are beyond the age when voluntary bladder
control should normally have been acquired
- Because this is expected at 2 to 3 years of age for daytime, 4 to 6 years of age for night time,
enuresis is said to occur at approximately 7 years. (Silbert-Flagg & Pillitteri, 2018)
- more common in boys and tends to be familial
- Can be defined as Primary (bedwetting in children who have never been dry for extended
periods) or Secondary (the onset of wetting after a period of established urinary continence).
- The passage of urine may occur only during night-time sleep, with the child remaining dry
during the day (Monosymptomatic), or the child has daytime urinary urgency and an occasional
daytime accident in conjunction with other conditions such as sleep disorders, urinary tract
infection, neurologic impairment, constipation, or emotional stressors (Polysymptomatic).
(Hockenberry, Wilson & Rodgers, 2017)
Classification of Enuresis
- Diurnal: wetting during the day
- Nocturnal: wetting during night time. Most enuresis is nocturnal.

II. Etiology
Possible causes of primary and secondary enuresis may include:
Causes of Primary Enuresis Causes of Secondary Enuresis
Idiopathic Idiopathic
Disorder of sleep arousal Disorder of sleep arousal
Nocturnal polyuria Nocturnal polyuria
Small nocturnal bladder capacity Small nocturnal bladder capacity
Overactive bladder or dysfunctional voiding Overactive bladder or dysfunctional voiding
Cystitis Cystitis
Constipation Constipation
Neurogenic bladder Psychological
Urethral obstruction Acquired neurogenic bladder
Psychological Seizure disorder
Ectopic ureter Obstructive sleep apnea
Diabetes insipidus Diabetes mellitus
Acquired diabetes insipidus
Acquired urethral obstruction
III. Pathophysiology

IV: Medical Management


 routine physical examination is performed to rule out physical causes
 diagnostic evaluation of function bladder capacity
 If psychological difficulties are evident, a routine psychiatric evaluation is warranted.
 hypnotherapy and motivational therapy
 restriction or elimination of fluids after the evening meal
 avoidance of caffeinated and sugar-containing beverages after 4 PM
 purposeful interruption of sleep to void
V. Nursing Intervention

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