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Sleep/Arousal and enuresis subtypes
1Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
The Journal of Urology
|November 7, 2001
Summary
Enuresis, or bedwetting, is linked to maturational delays. The severity of this delay correlates with the clinical presentation of enuresis in children.
Area of Science:
- Pediatric urology
- Developmental biology
Background:
- Enuresis (bedwetting) is a common condition in children with complex underlying mechanisms.
- Understanding these mechanisms is crucial for effective diagnosis and management.
Purpose of the Study:
- To review and compare bladder physiology mechanisms in children with and without enuresis.
- To elucidate the relationship between maturational delays and enuresis severity.
Main Methods:
- A comprehensive literature review was performed.
- Mechanisms of bladder physiology were compared between normal children and those with enuresis.
Main Results:
- Key mechanisms include nocturnal urine volume, functional bladder capacity, bladder contractions, and arousal difficulties.
- Evidence supports detrusor-dependent (contractions) and volume-dependent (polyuria) enuresis subtypes.
- Children with enuresis often have impaired arousal, particularly during the first two-thirds of the night.
Conclusions:
- Enuresis is primarily caused by maturational delays, with lag severity correlating to clinical picture severity.
- The spectrum of enuresis includes diurnal incontinence and secondary enuresis, both linked to maturation.
- Arousal ability is fundamental for achieving nighttime dryness.