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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

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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.

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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.