Enuresis (Daytime Wetting)
Enuresis means your child is not properly or not completely emptying their bladder. It can be used to describe various voiding dysfunction problems, such as daytime wetting, urine leakage or the frequent urge to use the bathroom. The condition is common and can range from mild to severe.
Enuresis can be embarrassing for children. It’s often frustrating for parents too. Our team will work with families to identify the cause and resolve the problem.
Enuresis often is a learned issue. In some cases, children may avoid using the bathroom because they don’t want to stop playing. Others may have had a urinary tract infection at one point that made it painful to urinate, and now they’re afraid. A child who had a difficult time potty training might have poor bathroom habits. .
Other potential causes include:
- Stress incontinence (urine leakage when coughing or sneezing)
- Giggle incontinence (urine leakage when laughing)
- Urinary tract problems that developed before birth
- Central nervous system, endocrine or kidney conditions
- Genetic diseases that affect the urinary tract
Signs and Symptoms
Daytime wetting may be the first sign of enuresis. When a child over age 4 has frequent daytime accidents with no obvious underlying medical cause, he or she may be diagnosed with enuresis.
Other symptoms include:
- Frequent or infrequent urination
- Urgent need to urinate without a full bladder
- Feeling like the bladder is full when it’s not
- Pain or straining with urination
- Hesitancy to urinate
- Leaking small amounts of urine
- Urinary tract infections
Our team works with the family to evaluate the child. This often begins with detailed questions about the child’s bathroom habits and frequency of accidents. A physical exam will be performed. Tests such as an ultrasound or X-ray may be necessary to rule out underlying medical causes. Urine might be checked for signs of infection.
The treatment for enuresis depends on the type and cause, as well as the child’s age.
In some cases, we may recommend the child use the bathroom on a timed schedule. Other measures, such as avoiding caffeine and treating constipation, might also be suggested.
If the child has frequent urinary tract infections, we will address that issue first.
If the child has difficulty emptying their bladder, we may recommend urinating twice in a row to empty their bladder more completely.
In some children, medication may be necessary to normalize bladder activity.
Nocturnal enuresis (Bedwetting)
There is no single cause for nocturnal enuresis, but certain factors, such as bladder capacity and genetics, may play a role.
Possible causes include:
- Small or underdeveloped bladder
- Overactive bladder, resulting in a sudden urge to urinate
- Underactive bladder, resulting in the inability to fully empty the bladder
- Urinary tract infection
- Stressful life events or general anxiety
- Deep sleep
- Poor bathroom habits (like being too busy playing to use the bathroom)
Nocturnal Enuresis Treatment and Diagnosis
Enuresis usually isn’t diagnosed in a child until at least age 5, but that depends on the severity of the problem.
Our team of providers will work with you to better understand why your child wets and recommend a treatment plan. We will assess your child’s medical history and conduct a physical exam. In more complex cases, we may perform diagnostic tests to look for an underlying medical condition. Such tests include:
- X-ray of the pelvis and abdomen
Possible treatments for enuresis include:
- Urinating on a schedule during the day
- Using an alarm at night to wake the child for a bathroom break
- Treating any underlying conditions (like constipation or urinary tract infection)
- Behavior modification
- Biofeedback training, which teaches the child how to relax pelvic muscles so they can empty their bladder
- Medications (for an overactive bladder)