Bedwetting, the origins of enuresis

BEDWETTING, THE ORIGINS The origin of bedwetting is often psychological or linked to a delay in toilet training. Thus, an overly rigid upbringing, a significant event such as the arrival of a baby or a younger brother can be the cause of bedwetting in children. Enuresis can also be caused by immaturity of the bladder system with deficiency of parasympathetic nerve inhibition. There are several predisposing factors associated with bedwetting. The first and most important factor is the genetic factor . Bedwetting is very often a hereditary condition. Discovering during a consultation that one's father or mother has already had this problem has the merit of demystifying the situation of the bedwetting child. The bladder factor: nocturnal enuresis appears as a delay in the maturation of the nerve pathways controlling urine production and nocturnal bladder function. Indeed, nocturnal polyuria (or nocturnal hyperdiuresis), resulting from a defect in nocturnal secretion of ADH (antidiuretic hormone) is found in 2/3 of enuretic children. Also, various studies have shown that the nocturnal bladder capacity of enuretic children is lower than that of "healthy" children and that bladder overactivity (or urgency) occurs in the first two-thirds of the night, during deep sleep, which explains why the child does not wake up. The sleep-wake factor: There's no doubt that bedwetting and sleep are closely linked. To be convinced, just listen to parents say that their bedwetting child is very difficult to wake up or that they sleep very soundly. Studies have shown that the sleep of enuretic children is normal, however their arousal mechanism is immature. This is why a bedwetting child with a full bladder does not wake up while a "healthy" child will wake up to urinate. From these last three predisposing factors, we easily understand the mechanism of enuresis: a reduced nocturnal bladder capacity associated with bladder contractions that would require emptying the bladder combined with an immaturity of the arousal system means that the child does not wake up to urinate. Other causes of bedwetting can include: Constipation may contribute, through uninhibited bladder contractions, to enuresis. Psychological factors: school anxiety, divorce, and other causes of psychological stress can be triggers for bedwetting.