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Enuresis nocturna: new concepts in pathophysiology

M C Uygur1, A Ergen, D Remzi

  • 1Department of Urology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

International Urology and Nephrology
|January 1, 1995
PubMed
Summary

Children with nocturnal enuresis have normal bladder capacity but produce increased nighttime urine. This is due to a loss of the usual daily variation in vasopressin levels, affecting urine concentration.

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Area of Science:

  • Pediatrics
  • Urology
  • Endocrinology

Background:

  • Nocturnal enuresis, or bedwetting, lacks a fully understood pathophysiology despite its long history.
  • Understanding the physiological basis of nocturnal enuresis is crucial for effective treatment.

Purpose of the Study:

  • To investigate the underlying physiological differences in children with nocturnal enuresis compared to healthy children.
  • To identify key factors contributing to increased nocturnal urine production in enuretic individuals.

Main Methods:

  • Comparison of functional bladder capacities between enuretic and normal children.
  • Measurement of diurnal vasopressin levels, urine osmolalities, and urine output in both groups.
  • Analysis of the relationship between vasopressin levels, urine concentration, and bladder capacity.

Main Results:

  • Enuretic children demonstrated normal functional bladder capacities.
  • Nocturnal urine volumes were found to be increased in enuretic children.
  • A loss of diurnal variation in serum vasopressin levels was observed in enuretic children, leading to decreased urinary osmolalities.

Conclusions:

  • Nocturnal enuresis is characterized by insufficient bladder capacity to accommodate increased nocturnal urine volumes.
  • The diminished capacity is linked to the loss of diurnal vasopressin variation and subsequent reduction in urine concentrating ability.

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