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Nocturnal enuresis: basic facts and new horizons
1Department of Pediatrics, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. kelm.hjalmas@mbox200.swipnet.se
Insights
Nocturnal enuresis, or bedwetting, is often caused by delayed maturation, not psychological issues. Early treatment is crucial for children
Area of Science:
- Pediatrics
- Urology
- Genetics
Background:
- Nocturnal enuresis (NE) in children is commonly misattributed to psychological factors.
- It stems from a hereditary delay in somatic maturation affecting bladder control during sleep.
- The condition persists into adulthood for a significant percentage if untreated.
Purpose of the Study:
- To challenge the traditional view of NE as self-limiting and innocent.
- To highlight the prevalence and lifelong impact of untreated NE.
- To emphasize the psychological burden and impact on self-esteem in affected children.
Main Methods:
- Review of recent research on the causes and prevalence of NE.
- Analysis of the developmental and psychological implications of NE.
- Consideration of treatment initiation based on the child's desire for dry nights.
Main Results:
- NE is primarily a maturational delay, not psychological.
- Over 5% of 7-year-olds and 0.5% of adults experience NE.
- Untreated NE significantly impairs a child's self-esteem and personality development.
Conclusions:
- NE requires timely intervention, contrary to the expectant approach.
- Addressing NE is vital for the child's psychological well-being and development.
- Treatment should be pursued when the child expresses a desire to achieve nighttime dryness.
Abstract:
Nocturnal enuresis in children is quite seldom due to psychological factors. Instead, it is caused by a hereditary delay in maturation of the somatic mechanisms (reduction of nocturnal urine production, relaxation of the bladder during sleeping hours, and a normal arousal to a full bladder) which prevent the child from wetting the bed. Doctors treating bedwetting children have often used an expectant attitude because nocturnal enuresis has been looked upon as self-limiting and innocent. According to recent research, this is not true. In children aged 7 years, more than 5% and in the adult population 0.5% report nocturnal enuresis. Thus, many enuretic children will remain bedwetters for life if left untreated. Furthermore, the child is ashamed and feels guilt because of his nocturnal enuresis which threatens to give a significant impairment of self-esteem at an age when an intact self-image is extremely important for an optimal development of the child's personality. Treatment should be given when the enuretic child wants to sleep dry.