Enuresis is the intentional or involuntary voiding of urine into clothes or other inappropriate places by a child who is at least 5 years old. To meet the criteria for enuresis, the involuntary or intentional voiding must occur at least twice a week or more for three months.

What is going on in the body?

In a child with enuresis, there is no physical disorder. Primary enuresis occurs when bladder control has never been achieved. Secondary enuresis occurs when bladder control has been achieved for at least one year but has then been lost. Enuresis may occur only at night, only in the day, or during both day and night.

What are the causes and risks of the condition?

Causes of enuresis are usually psychosocial and physiologic. Children with enuresis often have other developmental delays. They tend to have smaller bladders and a higher likelihood of a learning disability. A link between enuresis and a sleep disorder may be involved, but there is no clear proof of this.

Genetics may also play a role in the development of enuresis. Having one enuretic parent increases the chance of the child having enuresis by 45%. If both parents are enuretic, the risk increases to 75%. About twice as many males as females are enuretic.

Some cases of enuresis are related to toilet training that was begun too early or was very forcible. Enuresis may be a temporary regression or an adjustment problem. Parents who are very controlling and quick to find fault may also trigger problems with bladder control.

Medical causes of enuresis include the following: