Bedwetting (Nocturnal Enuresis) | Symptoms & Causes
What causes bedwetting?
There is no single cause of bedwetting. In many children, it can be due to several different factors, such as:
- genetics
- small bladder capacity
- sleep apnea
- urinary tract infections (UTIs)
- structural or anatomical differences
- diabetes
- neurogenic bladder
- constipation
Although bedwetting sometimes occurs if your child is feeling emotional stress or insecurity, it isn’t usually a behavioral issue. Instead, there is more evidence suggesting that enuresis is the result of a developmental delay in the normal process of achieving nighttime control. The normal process involves the release of a hormone that prompts the kidneys to slow down production of urine during nighttime sleep. This hormone, called vasopressin, is not secreted enough in many children who have a problem at night.
Bedwetting (Nocturnal Enuresis) | Diagnosis & Treatments
How is bedwetting diagnosed?
If your child is toilet trained but wetting the bed, it's a good idea to set up a consultation with a pediatric urologist.
This can be important to help tailor therapy and ensure that there are no medical or structural problems that may be contributing to or causing the nighttime wetting. For this reason, a careful history of your child's complete voiding habits and bowel habits will be important.
Here are some additional tests that your doctor may recommend:
- Urinalysis to check for UTI, diabetes, or abnormal kidney function
- Renal bladder ultrasound. This imaging examination is used to determine the size and shape of your child's kidney and bladder, and to detect a mass, stone, cyst, or other obstruction or abnormalities.
How is bedwetting treated?
Most children will eventually outgrow bedwetting as they get older. Sometimes simple measures, such as sticker charts or an alarm to wake your child if wetting occurs, can be helpful. Bedwetting is not harmful to your child in any way other than its impact on self-esteem.
If your child is embarrassed to attend camp or a sleepover, you may want to talk with your pediatric urologist about some of the following therapies:
- behavior modification (for example, no fluids after 6 p.m.)
- conditioning therapy (alarm systems, which we will explain you)
- drug therapy that includes DDAVP, which replaces the natural hormone vasopressin
The dedicated clinicians at Boston Children’s CHEER will work with your family to find the approach that works best for your child.
