Diurnal enuresis is daytime wetting (functional daytime urinary incontinence).

Nocturnal enuresis Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can inc ...

is nighttime wetting.

Enuresis Enuresis is a repeated inability to control urination. Use of the term is usually limited to describing people age-appropriateness, old enough to be expected to exercise such control. Involuntary urination is also known as urinary incontinence. Th ...

is defined as the involuntary voiding of urine beyond the age of anticipated control. Both of these conditions can occur at the same time, although many children with nighttime wetting will not have wetting during the day. Children with daytime wetting may have

frequent urination Frequent urination, or urinary frequency (sometimes called pollakiuria), is the need to urinate more often than usual. Diuretics are medications that increase urinary frequency. Nocturia is the need of frequent urination at night. The most common ...

, have

urgent Urgent may refer to: * Urgent (American band), a 1980s band from New York City * Urgent (Canadian band), a 1980s band from Toronto, Ontario, Canada * "Urgent" (song), a 1981 song by Foreigner * Urgent! Records, a former record company See also ...

urination or dribble after urinating. The

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...

classifies enuresis as an

elimination disorder Elimination may refer to: Science and medicine *Elimination reaction, an organic reaction in which two functional groups split to form an organic product *Bodily waste elimination, discharging feces, urine, or foreign substances from the body ...

and as such it may be defined as the involuntary or voluntary elimination of urine into inappropriate places. A patient must be of at least a developmental level equivalent to the chronological age of a 5 year old in order to be diagnosed with enuresis (in other words it is not abnormal for a child below the age of 5). The patient must either experience a frequency of inappropriate voiding at least twice a week for a period of at least 3 consecutive months OR experience clinically significant distress or impairment in social, occupational or other important areas of functioning, in order to be diagnosed with enuresis. These symptoms must not be due to any underlying medical condition (e.g. a child who wets the bed because their

kidneys In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retro ...

produce too much urine, does not have enuresis, they have kidney disease which is causing the inappropriate urination). Also, these symptoms must not be due exclusively to the direct physiological effect of a substance (such as a

diuretic A diuretic () is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics ...

antipsychotic Antipsychotics, previously known as neuroleptics and major tranquilizers, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), p ...

Causes

Common causes include, but not limited to: * Incomplete emptying of the

bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...

* Irritable

Constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The Human feces, stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the ...

* Stress *

Urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...

* Urgency (not "making it" to the bathroom in time) * Anatomic abnormality * Poor toileting habits * Small

capacity * Medical conditions like overactive bladder disorder

Management

Management approaches include reassuring families that the child is not wetting their pants on purpose and treatment should include positive reinforcement (not punishment). Non-invasive treatments include keeping a diary to track when the child does not make it to the bathroom on time, ruling out and treating urinary tract infections, ensuring the child is not constipated, hydration, timed voiding, correction of

constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The Human feces, stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the ...

, and in some cases, computer assisted pelvic floor retraining. The effectiveness of non-surgical and non-pharmaceutical interventions for treating children with daytime urinary incontinence is not clear.

Bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...

stretching exercises (where the person tries to hold their urine as long as possible) are no longer recommended. Bladder stretching exercises can be dangerous because the person could develop the long-term habit of tightening the

urethral sphincter The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the external sphincter muscle of male urethra, male or external sphincter muscle of female urethra, fe ...

muscle, which can cause

kidney In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and rig ...

problems.

Urinating Urination is the release of urine from the bladder through the urethra in placental mammals, or through the cloaca in other vertebrates. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresi ...

on a regular basis is suggested.

Epidemiology

Daytime wetting is more common in girls, while

bedwetting Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can inclu ...

is three times as prevalent in boys (i.e., around 75% of those affected are male). At the age of 7 approximately 3% of girls and 2% of boys experience functional daytime wetting at least once a week."http://www.eric.org.uk/DaytimeWetting/info_daytime_wetting_professionals "

References

External links

{{Urinary system symptoms and signs Symptoms and signs: Urinary system Toilet training Urine