Enuresis - clinical fact sheet and MCQ

Overview

Enuresis, commonly referred to as bedwetting, is the involuntary release of urine during sleep in children over 5 years of age. ‘Enuresis’ is reserved for nighttime wetting, while daytime wetting is classified separately as urinary incontinence. Enuresis can be further categorised as primary, where the child has never achieved a prolonged dry period, and secondary, where bedwetting recurs after at least 6 months of dryness. 

The condition affects up to 10% of 5-year-olds and tends to decrease with age, with only about 1% of those aged 15 and older still affected. Boys are twice as likely to experience enuresis compared to girls. Emotional support and a non-punitive approach from parents/carers are essential, as bedwetting can affect self-esteem and psychological wellbeing.

Enuresis involves a discrepancy between nocturnal urine production and functional bladder capacity, coupled with an inability to wake from sleep when the bladder is full. Additional aetiological factors include nocturnal polyuria (such as from lack of nocturnal antidiuretic hormone secretion), abnormally reduced bladder capacity, and sleep arousal disorders.

Risk factors for enuresis include: