Everyone has wet the bed at some point in their lives. For babies and young children, it’s normal, expected, and the way we’re made. But when we talk about bedwetting, it’s pretty understood that we’re referring to older children or adults, those past the accepted age for involuntary wetting.
When any human behavior is outside the norm, we begin looking at it medically and give it a medical name so that we can get some help from the experts. The medical term for bedwetting is nocturnal enuresis. Enuresis is the term for wetting and nocturnal indicates that it occurs at night.
What is enuresis? The Official Definition
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), an official diagnosis of enuresis must meet certain criteria. Here are the official criteria that define enuresis.
- Repeated voiding of urine into the bed or clothes, either involuntary or voluntary.
In other words, the child wets the bed or his or her clothes more than once. It’s something that happens regularly. Official enuresis is not a one-time occurrence.
- The behavior occurs at least twice a week for at least 3 consecutive months, it causes significant distress, OR it impairs functioning.
Even if the wetting does not repeat for the full three months, if it causes distress or makes everyday life difficult, it’s still enuresis.
- The behavior occurs in a child who is at least 5 years old.
This is important. Some parents feel frustration or concern when their 3 or 4 year old is potty trained during the day, but still wetting the bed at night. Frustration may be normal, but there’s no reason for concern. Enuresis is not diagnosed until at least 5 years old.
- The behavior cannot be attributed to physical effects of a substance or other medical condition.
Certain medications or supplements can cause incontinence. If that’s what’s going on, then it does not qualify as enuresis. Likewise, if diabetes, spina bifida, a seizure disorder, or another condition are causing wetting, then there is not enuresis.
Enuresis is the catch-all medical term for all wetting. But we’re talking on this website about wetting the bed – at night.
Nocturnal, Diurnal, and Nonmonosymptomatic Enuresis
Nighttime bedwetting is the most common type of enuresis. In fact, the terms enuresis and nocturnal enuresis are often used interchangeably. Nonetheless, bedwetting at night is officially nocturnal enuresis.
Diurnal enuresis refers to wetting during the day. This might be regular accidents or simply dribbling. It’s not unusual for children who are potty trained to dribble in their underwear as they are learning all their body’s signals that it’s time for a bathroom break. Diurnal enuresis is more than this. It must fit all the criteria listed above.
I’m covering nonmonosymptomatic enuresis for two reasons. First, it’s an official distinction of a certain type of enuresis, just like nocturnal and diurnal. It means that the enuresis occurs both during the night and during the day.
The second reason I’m covering it is because the word is just too impressive not to share. I wonder if it could be worked into my vocabulary in other instances :). In any case of anything out there, if there is more than one symptom, it’s nonmonosymptomatic.
Primary Enuresis
There are two kinds of nocturnal enuresis, or bedwetting. First is primary enuresis, the most common classification of nocturnal enuresis.
Primary enuresis is the term used for a child who has always wet the bed. This child has never gone through a period of dryness, or not wetting the bed at night.
A child with primary enuresis has never learned to control his or her bladder for one reason or another. Some feel that perhaps the bladder or other physical features of the child with primary enuresis have not fully developed.
Other suggested causes include diet, constipation, hormones, and genetics.
These are the children of whom it is often said, “They’ll grow out of it.” Some do, some don’t. One of mine did not. He needed some extra help.
Secondary Enuresis
Secondary enuresis refers to the child who was dry for at least six months (sometimes for years) and then started to wet the bed at night again. About 25% of children with nocturnal enuresis fall into this category.
Two issues are at play here. First, why has the child started wetting the bed again? In truth, no one knows for sure why a child begins wetting the bed after a period of dryness. Some causes are straight forward, but most are not.
Possible reasons are medical conditions like a urinary tract infection (UTI) or diabetes, sleep problems, physical development, and psychological stress.
The second issue is the stress that secondary enuresis can cause. These are children who have been dry, the developmental milestone was met. And now they’ve begun wetting the bed.
Embarrassment, anxiety, and loss of self-esteem are common for these kids. Unfortunately, all those negative emotions do nothing for achieving dry nights. In fact, the stress can further affect bedwetting. It’s a viscous cycle.
We Know What It’s Called, Now What?
Frustrating as it is, while the medical community has named bedwetting, there remain a huge number of questions.
Doctors and researchers readily admit that they do not know definitively what causes bedwetting in every case. Without knowing the cause, then treatment is tricky. Nonetheless, there are a number of treatments available.
When Should You See A Doctor For Bedwetting?
For children, parents should see a doctor if they are at all concerned about a medical cause for their child’s bedwetting, such as a urinary tract infection. For adults who have started wetting the bed, they should see a doctor immediately to test for more serious medical conditions.
In either case, a doctor will most likely take a complete medical history, a full physical exam, and a urine test. From there, possible treatments will be explored, including therapies and different medications.
It really is a small number of children who have an underlying medical issue causing nocturnal enuresis. Time and again, in my research, I see doctors advising parents to wait it out, children achieve nighttime dryness at different ages. And that’s true.
If, though, your child is ready to be dry, motivated to beat nocturnal enuresis, then there are treatments available. My favorite, of course, is My Bedwetting Victory. It completely cured my children of nocturnal enuresis – and the emotional strain of bedwetting.
Conclusion
The medical community has given bedwetting a name: nocturnal enuresis. While the term enuresis by itself technically covers all forms of wetting, it’s often used to indicate wetting the bed. Even so, the official medical term for bedwetting is nocturnal enuresis.
And then there’s diurnal enuresis, which is wetting during the day.
Primary enuresis indicates someone who has never mastered staying dry at night, and secondary enuresis indicates someone who was dry for a season, but then started wetting.
While the medical terms help to clarify our conversations, they do not cure bedwetting. The search continues for a clear cause. Meanwhile, treatments are available, and a cure is possible.
*This article does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.
References
- Cendron, Marc MD, “Primary Nocturnal Enuresis: Current Concepts”, American Family Physician, 1999, https://www.aafp.org/afp/1999/0301/p1205.html
- National Kidney Foundation, “Secondary Nocturnal Enuresis”, 2015, https://www.kidney.org/patients/bw/BWbedwetSecondary
- Robson, Wm Lane M., “Enuresis”, Medscape, Jan. 16, 2018, https://emedicine.medscape.com/article/1014762-overview#a2
