Enuresis

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Editor(s)-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Angela Botts, M.D., Beth Israel Deaconess Medical Center Geriatric Medicine [2]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [3]

Overview

Enuresis is the medical term for involuntary urination beyond the age of anticipated control. Its two major forms are diurnal enuresis (or daytime wetting), and nocturnal enuresis (bedwetting or nighttime wetting). It can be controlled with medications such as oxybutynin.

Differential Diagnosis

• Medication side effects
  • Sodium oxybate
• Neurogenic bladder

Epidemiology and Demographics

Prevalence

The prevalence of enuresis is:

• 5,000-10,000 per 100,000 (5%-10%) among children 5 years of age
• 3,000-5,000 per 100,000 (3%-5%) among children 10 year of age
• 1,000 per 100,000 (1%) among children 15 years of age or older

Risk Factors

• Delayed or lax toilet training
• Genetic predisposition
• Psychosocial stress

Diagnostic Criteria

DSM-V Diagnostic Criteria for Enuresis

“

A. Repeated voiding of urine into bed or clothes, whether involuntary or intentional. AND B. The behavior is clinically significant as manifested by either a frequency of at least twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning. AND C. Chronological age is at least 5 years (or equivalent developmental level). AND D. The behavior is not attributable to the physiological effects of a substance (e.g., a diuretic, an antipsychotic medication) or another medical condition (e.g., diabetes, spina bifida, a seizure disorder). Specify whether: Nocturnal only: Passage of urine only during nighttime sleep. Diurnal only: Passage of urine during waking hours. Nocturnal and diurnal: A combination of the two sub types above.

”

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