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Provoked enuresis-like episodes in healthy children 7 to 12 years old
J Kirk1, P V Rasmussen, S Rittig
1Institute of Experimental Clinical Research, University of Aarhus, Denmark.
Insights
A water load before bed can provoke enuresis-like episodes in healthy children, often involving incomplete bladder emptying. These findings suggest nocturnal polyuria and arousal difficulties may contribute to bedwetting.
Area of Science:
- Pediatric Urology
- Sleep Medicine
Background:
- Nocturnal enuresis, or bedwetting, affects many children.
- Understanding its triggers is crucial for effective management.
Purpose of the Study:
- To investigate if a bedtime water load provokes enuresis in healthy children without prior history.
- To examine pelvic floor activity and bladder emptying during provoked episodes.
- To identify potential triggers and age/sex differences in enuresis provocation.
Main Methods:
- 55 healthy children (7-12 years) without enuresis history participated.
- Subjects underwent 4 nights of monitoring, with a water load on nights 2-4.
- Pelvic floor activity, enuresis, and nocturia episodes were recorded.
Main Results:
- 28 enuresis-like episodes were provoked in 17 children.
- Episodes often involved incomplete voiding with significant residual urine, particularly in younger boys.
- Provoked episodes occurred at individual-specific bladder volumes, irrespective of filling rate.
Conclusions:
- Bedtime fluid intake can trigger enuresis-like episodes in susceptible children.
- Nocturnal polyuria is a significant factor in enuresis development.
- Arousal failure may be a contributing mechanism, even in non-enuretic individuals.
Purpose:
We evaluated whether a water load before bedtime provoked enuresis episodes in healthy children with no previous enuresis. We also studied pelvic floor activity during an enuresis episode and the completeness of bladder emptying, attempted to identify a possible trigger mechanism for nocturnal enuresis, and investigated any age and sex differences regarding the frequency of provoked enuresis episodes.
Materials And Methods:
We evaluated 55 healthy volunteers (22 girls and 33 boys) 7 to 12 years old who were dry from age 5 years and had no urological or other complaints. Subjects were admitted to the hospital for 4 consecutive nights. Night 1 was for adaptation without a water load. On nights 2 to 4, 25 ml./kg. body weight of water were given orally half an hour before bedtime. During the night pelvic floor activity was monitored, and the time and volume of enuresis and nocturia episodes were noted.
Results:
In 17 subjects 28 enuresis-like episodes were provoked, generally comprising incomplete voidings with large residual volumes mostly in younger children and in boys. Enuresis and nocturia episodes were provoked at a volume specific for each individual without a relation to the bladder filling rate.
Conclusions:
Our results support the hypotheses that nocturnal polyuria is an important pathogenetic factor in enuresis and that arousal failure can be provoked in nonenuretic subjects.