Enuresis is a condition in which a person involuntarily urinates during sleep, in the absence of an organic cause (American Psychiatric Association, 2013). It is classified as a disorder of elimination, and is most commonly seen in children, but can also occur in adults (Blomqvist & Sillanpaa, 2011).
The exact etiology of enuresis is still unknown, but certain factors have been linked to its development. These include genetics, environmental factors, psychological factors, and physiological factors (Blomqvist & Sillanpaa, 2011). For example, there is evidence that suggests enuresis is heritable, with a positive family history in up to 60% of cases (Blomqvist & Sillanpaa, 2011). Additionally, environmental factors such as the family dynamics, sleep deprivation, and stress can contribute to the development of enuresis (Blomqvist & Sillanpaa, 2011). Psychological factors, such as anxiety, depression, and attention-deficit/hyperactivity disorder, can also play a role in the development of enuresis (Blomqvist & Sillanpaa, 2011). Lastly, physiological factors have been linked to enuresis, such as low levels of antidiuretic hormone, urinary tract infections, and bladder instability (Blomqvist & Sillanpaa, 2011).
The diagnosis of enuresis is typically made by a healthcare provider after a physical examination and collection of a thorough medical history, including a family history (American Psychiatric Association, 2013). Treatment for enuresis typically includes bladder retraining, behavior modification, and in some cases, medications (American Psychiatric Association, 2013). Bladder retraining involves having the patient increase the intervals between voids and practice double voiding to help increase bladder capacity (American Psychiatric Association, 2013). Behavior modification interventions may include positive reinforcement for dry nights, or punishment for wet nights (American Psychiatric Association, 2013). Medications such as desmopressin, an antidiuretic hormone analog, can also be used to help reduce the frequency of nighttime wetting (American Psychiatric Association, 2013).
Enuresis is a common condition that can have a significant impact on a person’s quality of life. It is important to note that enuresis can be managed with proper treatment and intervention. Healthcare providers should be aware of the etiology, diagnosis, and treatment of enuresis in order to provide appropriate care to their patients.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Blomqvist, P., & Sillanpaa, M. (2011). Recent advances in enuresis. Nature Reviews Urology, 8(12), 693-700.