ENURESIS

the term enuresis applies to children over the age of 5 who have

wet the bed all their lives or
have more recently lost bladder control

nocturnal enuresis- ‘repeated involuntary passage of urine during sleep in the absence of any identified physical abnormality in children above 5.’

*the child will usually be examined first by a doctor in case there is a physical cause for the bedwetting, although this is uncommon

*when a child wets the bed it seems that his / her brain is not properly aware of the amount of urine in the bladder, allowing it to empty automatically while he / she is sleeping.

EFFECTS

	source of embarrassment to the sufferer, sometimes invoking ridicule, punishment, bullying
	can place intolerable burden on family relationships, especially in large families where there is overcrowding, where several children may wet the bed
	carries adverse social consequences
	children can tend to exhibit some level of reactive emotional disturbance
	can place a limit on the child’s choice of activities (e.g. difficult to go camping / stay at friends’ houses)
	daily washing of clothes / bed-linen can become onerous
	can create an unpleasant odour

PREVALENCE – SOME STATISTICS

	The likelihood that a child will become spontaneously continent over 12month period is sharply reduced aver the age of 4. (Shaffer, 1994)
	Nocturnal bedwetting at least once a week occurs in approximately 13% of boys or 13% of girls of 5 years old (Rutter, Tizard & Whitmore, 1970)
	Prevalence rate for young people over 15 and adults is 1%-2%
	Very common amongst children in residential establishments, and can continue into late adolescence / adulthood if left untreated
	Daytime wetting (diurnal enuresis) is present in approximately 1 in 10 nocturnal enuretics
	Bedwetting is about equally common in boys and girls until 5 years of age. After then, by age 11, they are twice as likely to be wet as girls.(Essen & Peckham, 1976)

POSSIBLE CAUSES

	Faulty learning – harsh pressurising / complacent neglect of training
	Resulting emotional problems when the child is made to feel shame for their babyish ways, possibly both at home and school
	Urological / medical (e.g. small functional bladder capacity, genetics, maturation, developmental disorders
	Psychological factors

Physical causes

	10% of all cases of enuresis are the result of medical (physical) conditions, most commonly, urinary tract infection
	approximately 1 in 20 female and 1 in 50 male enuretics have such an infection
	other uncommon physical causes – chronic renal / kidney disease, diabetes, tumours, seizures
	runs in families – 70% of clinically referred enuretics have a first-degree relative who was enuretic as a child

Emotional influences

	relationship between bedwetting and anxiety
	children who bed-wet also tend to be anxious or nervous children
	several studies have found that as bedwetting is treated, there is a decrease in anxiety / an improvement in the way the child feels about him/ herself
	when looking at the effects of enuresis on the child, this explanation seems plausible

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