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Enuresis (Bedwetting)

Bedwetting at night is a common childhood problem after the toilet-training age.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Enuresis (Bedwetting)?

Nocturnal enuresis is defined as urinary incontinence during sleep at least twice a month in a child aged 5 and over. There are two forms: primary enuresis (never having had a dry night) and secondary enuresis (recurring after at least 6 months of dryness).

Pathophysiological mechanisms: nocturnal antidiuretic hormone (ADH/vasopressin) deficiency, decreased bladder capacity, and elevated arousal threshold due to deep sleep. Secondary enuresis may begin due to medical causes such as stress, urinary tract infection, or type 1 diabetes.

The spontaneous resolution rate is 15% per year; in many children, the issue resolves at adolescence even untreated. However, the psychosocial burden on the family and self-esteem issues in the child may necessitate treatment.

Symptoms

Bedwetting during sleep at night (≥5 years, ≥2 times/month)
In the secondary form, recurrence in a previously dry child
Polydipsia and polyuria (diabetes or diabetes insipidus should be investigated)
Accompanied by daytime urinary incontinence (combined form)
Burning during urination (with UTI)
Constipation (pressure on the bladder)

Risk Factors

Family history of enuresis (strong genetic predisposition)
Male sex (more common)
ADHD and autism spectrum disorder
Stress and intra-family changes (secondary form)
Constipation
Urinary tract infection

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For ongoing nighttime wetting at age 5 and over
  • When secondary enuresis starts (to investigate medical causes)
  • If polydipsia, polyuria, or weight loss accompany (to rule out diabetes)
  • If daytime incontinence or voiding dysfunction is also present

Treatment Methods

01
Alarm therapy: the method with the highest long-term success rate
02
Desmopressin (DDAVP): ADH analog, reduces nighttime urine production
03
Lifestyle: nighttime fluid restriction, evening toilet plan
04
Bladder training and regular toilet habits
05
Constipation treatment: should be addressed first in concomitant cases
06
Psychological support: targets self-esteem and family stress

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.