What Is It?
Bedwetting, also called nocturnal enuresis, means that a child accidentally passes urine at night during sleep. Because this is normal in infants and very young children, bedwetting is not considered a medical problem unless it happens in a child who is already in elementary school or who was completely dry day and night and then began to wet the bed again during the night.
By age 5, 80% to 85% of children are consistently dry throughout the night. After age 5, the number of children who continue to wet the bed decreases by about 15% per year, even without treatment. Only 1% of children still wet the bed by the time they are 15 years old.
To help make diagnosis and treatment easier, doctors sometimes classify bedwetting into two types, primary and secondary nocturnal enuresis. In primary nocturnal enuresis, the child has never been consistently dry at night. In secondary nocturnal enuresis, the child has been dry at night for at least three to six months (or one year, according to some experts) and has begun to wet the bed again. It is very important to remember that in both types, the child is not wetting the bed on purpose.
Primary Nocturnal Enuresis
Although the specific combination of factors varies from child to child, the result is the same — bedwetting. In a small number of cases, primary nocturnal enuresis arises from a purely medical problem, such as a physical defect in the child's urinary tract, a neurological problem related to the spinal nerves or brain, or a urinary tract infection.
Secondary Nocturnal Enuresis
Almost any change in the environment — good or bad — can be a trigger; for example, a new baby, a death in the family, parents' divorce or marriage problems, a new home or school, or even a long visit from relatives. Secondary bedwetting may be related to sexual abuse or to extreme bullying. Rarely, this form of bedwetting is related to a medical problem, such as a urinary tract infection or diabetes, and in these cases there are usually other obvious symptoms of medical illness.
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