(Enuresis; Primary Nocturnal Enuresis; PNE)
- Primary nocturnal enuresis (PNE)—no periods of nighttime dryness
- Secondary nocturnal enuresis (SNE)—periods of nighttime dryness longer than 6 months followed by bed-wetting
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- Bladder control that develops more slowly than normal
- Greater than average urine production at night
- A tendency for deep sleep
- Overactive bladder
- Family members with a history of bed-wetting
Significant psychosocial stressors, such as:
- Family difficulties
- Moving to a new home
- Loss of a loved one
- A new baby in the home
- Initial toilet training that was too stressful
- Physical or sexual abuse
- Chronic constipation
- Attention deficit hyperactivity disorder
When Should I Call My Doctor?
- Wets their pants in the daytime
- Has pain during urination
- Has to go to the bathroom often
- Has blood in the urine
- Has fever or chills
- Family history of bed-wetting
- Daytime urinary patterns
- Problems urinating, such as pain or weak stream
- Usual intake of fluids
- Type of fluids consumed
- Presence of blood in the urine
- Strained family dynamics around the issue of bed-wetting
- Child's emotional response to the behavior
- Recent psychological trauma
- Urine sample—to check for infections and other problems with the urinary tract
- X-rays or ultrasound —if physical abnormalities are suspected
Motivation and Family Support
- Desmopressin (DDAVP)—a hormone that decreases the amount of urine that is made
- Imipramine—an antidepressant that lightens the level of sleep and may also decrease how often your child urinates
- Oxybutynin—may reduce bladder overactivity and frequency of nighttime wetting
American Academy of Child and Adolescent Psychiatry http://www.aacap.org/
American Academy of Pediatrics http://www.healthychildren.org/
About Kids Health http://www.aboutkidshealth.ca/
Alberta Health and Wellness http://www.health.gov.ab.ca/
Bed wetting (enuresis). American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Bed-Wetting-Enuresis.aspx . Updated May 26, 2011. Accessed August 7, 2012.
Enuresis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated July 19, 2012. Accessed August 7, 2012.
Facts for families: bed wetting. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/cs/root/facts%5Ffor%5Ffamilies/bedwetting . Updated December 2011. Accessed August 7, 2012.
Lee T, Suh HJ, Lee HJ, Lee JE. Comparison of effects of treatment of primary nocturnal enuresis with oxybutynin plus desmopressin, desmopressin alone, or imipramine alone: a randomized controlled clinical trial. J Urol . 2005;174:1084-1087.
Robson WL. Clinical practice. Evaluation and management of enuresis. N Engl J Med . 2009 Apr 2;360(14):1429-1436.
Robson WL, Leung AK, Van Howe R. Primary and secondary nocturnal enuresis: similarities in presentation. Pediatrics . 2005 Apr;115(4):956-959.
12/13/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 2007 Safety Alerts for Drugs, Biologics, Medical Devices, and Dietary Supplements: Desmopressin acetate (marketed as DDAVP Nasal Spray, DDAVP Rhinal Tube, DDAVP, DDVP, Minirin, and Stimate Nasal Spray). US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Desmopressin . 2007 Dec 4.
9/23/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Glazener C, Evans J, Peto RE. Complex behavioural and educational interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews. 2004(1). CD004668. DOI: 10.1002/14651858.CD004668.
10/10/2013 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mellon M, Natchey B, Katusic S, et al. Incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder in a population-based cohort. Acad Pediatr. 2013 Jul-Aug;13(4):322-7.
- Reviewer: Kari Kassir, MD
- Review Date: 09/2013
- Update Date: 09/30/2013