Enuresis (Urinary Incontinence)

Enuresis is the medical term for involuntary urination or “wetting.” Other words for this problem include incontinence, voiding problems, or urinary accidents. Most children have control of their bladders by age 4 for daytime control and by age 6 for nighttime control, but up to 20 percent of first-grade boys, 6 to 7, and 17 percent of first-grade girls have problems with wetting accidents.

Enuresis can occur at night (nocturnal enuresis or bedwetting) or during the day (diurnal enuresis).

There is no single cause for daytime or nighttime wetting, but doctors believe that certain factors, such as bladder capacity and genetics, may play a role. Other reasons include:

• small functional bladder capacity
• difficulty with sleep arousal or the presence of a sleep disorder
• a problem with the proper functioning of hormones that help to regulate urine volume
• genetics (enuresis tends to run in families)
• delay of your child’s body’s ability to hold urine (this may be a factor up to about age 5)
• constipation, which is backed-up stool in your child’s intestine that can push against the bladder and cause accidental urination
• child is too busy to stop and fully empty their bladder or they may not notice the bladder is full

It’s also possible that other medical conditions may be causing your child’s enuresis:

• recurrent urinary tract infection (UTI)
• diabetes
• sickle cell disease

Depending on the type and severity of enuresis, possible treatments include nighttime alarms to wake the child to go to the bathroom, medications, bladder training, and positive reinforcement.

A visit to a doctor that specializes in treatment of enuresis can help to identify the best treatment option to help your child. Identifying the problem earlier can help reduce stress and emotional discomfort a child can experience with wetting accidents.

Facts about enuresis

• It affects 10 to 20 percent of boys ages 6 to 7.
• It affects 8 to 17 percent of girls ages 6 to 7.
• Of the children with enuresis, 74 percent of them have wetting at night, 10 percent have wetting during the day, and 16 percent have both.
• About 15 percent of all 5-year-olds have nighttime bedwetting.
• About 7 percent of 8-year-olds have nighttime bedwetting.

What are the long-term effects?

Enuresis goes away on its own in 15 percent of kids each year. So, the older your child gets — even if you elect to have no treatment at all — the more likely he is to stay dry.

However, children who have wetting problems because of an underlying medical issue may require longer treatment and care.

How Boston Children's Hospital addresses enuresis

Boston Children’s has created the Voiding Improvement Program (VIP) to help children who have enuresis.

Expert physicians and nurse practitioners take a comprehensive approach to helping children overcome voiding difficulties. Request an appointment online or call us at 617-355-7796.