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Bedwetting (Nocturnal Enuresis)

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What Is Enuresis?

Alex falls into an extremely deep sleep almost every night. He sleeps so soundly that you could set off a fire alarm next to his bed and he probably wouldn't hear it. Even having to pee doesn't wake him up, so Alex sometimes wets the bed. He feels embarrassed, but isn't alone — this problem affects about 1-2 out of every 100 teens.

The medical name for not being able to control your pee is enuresis (pronounced: en-yuh-ree-sis). Sometimes enuresis is also called involuntary urination. Nocturnal enuresis is involuntary urination that occurs at night. (Involuntary urination that happens during the day is known as diurnal enuresis.)

There are two kinds of enuresis: primary and secondary. Someone with primary nocturnal enuresis has wet the bed since he or she was a baby. Secondary enuresis is a condition that develops at least 6 months — or even several years — after a person has learned to control his or her bladder.

The bladder is a muscular receptacle, or holding container, for pee (urine). It expands (gets bigger) as urine enters and then contracts (gets smaller) to push the urine out.

In a person with normal bladder control, nerves in the bladder wall send a message to the brain when the bladder is full; the brain then sends a message back to the bladder to keep it from automatically emptying until the person is ready to go to the bathroom. But people with nocturnal enuresis have a problem that causes them to pee involuntarily at night.

What Causes Enuresis?

Doctors don't always know the exact cause of nocturnal enuresis. They do have some theories, though, on what may contribute to someone developing the condition:

Doctors don't know exactly why, but more than twice as many guys as girls have enuresis. It is frequently seen in combination with ADHD.

How Is Enuresis Diagnosed?

If you're having trouble controlling your urine at night, talk to your doctor to learn more about nocturnal enuresis and to rule out the possibility of a medical problem.

In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history. He or she may ask about sleep patterns, bowel habits, and urinary symptoms (such as an urge to pee a lot or pain or burning when you pee). Your doctor may also discuss any stressful situations that could be contributing to the problem.

The initial exam will probably include a urinalysis and urine culture. In these tests, urine is examined for signs of disease. Most of the time in people with nocturnal enuresis, these test results come back completely normal.

How Is It Treated?

Doctors can do several things to treat bedwetting, depending on what's causing it. If an illness is responsible, which is not very common, it will be treated. If the history and physical examination do not suggest a specific medical problem and the urine tests are negative, several behavioral approaches can be used for treatment:

If you're worried about enuresis, the best thing to do is talk to your doctor for ideas on how to cope with it. Your mom or dad can also give you tips on how to cope, especially if he or she had the problem during adolescence.

The good news is that it's likely that bedwetting will go away on its own. In fact, 15 out of 100 kids who wet the bed will stop every year without any treatment at all.

Reviewed by: Mary L. Gavin, MD
Date reviewed: January 2012
Originally reviewed by: Robert Walter, MD

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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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