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The different types of bedwetting

Bedwetting might seem simple on the surface, but there are different types of bedwetting: primary, secondary, nocturnal and diurnal enuresis.

Children jumping on a bed.

Understanding the different types of bedwetting: primary vs secondary; nocturnal vs. diurnal enuresis

Bedwetting, known as ‘enuresis’ in the medical world, can be a distressing experience for both children and their parents. Understanding the various types of bedwetting can help you better navigate this common childhood issue. Bedwetting can be categorised based on the time of day it occurs and whether it has persisted since potty training or reappeared after a dry period.

Primary enuresis

Primary enuresis, or primary bedwetting, is the most prevalent type among children. This condition is identified when a child wets their bed or clothes consistently within the first six months of potty training. Essentially, the child never fully mastered toilet training and the bedwetting is a continuation of that phase.

Over 75 per cent of children with bedwetting issues suffer from primary enuresis, which is more common in boys than in girls. This type of bedwetting occurs because the child's brain hasn’t yet developed the ability to recognise the signals from a full bladder during sleep. Consequently, the child does not wake up to use the bathroom.

Primary enuresis isn't usually considered problematic until around the age of five, as it might simply indicate that a child's potty training is incomplete. Most children outgrow this type of bedwetting as their bodies and brain-bladder communication mature.

Secondary enuresis

Secondary enuresis is characterised by the onset of bedwetting after a child has enjoyed at least six months of nighttime dryness. This type accounts for about 25 per cent of all bedwetting cases and can significantly impact a child's self-esteem and school performance.

A child experiencing secondary enuresis may feel embarrassed or upset, especially after previously achieving dry nights. Unlike primary enuresis, secondary enuresis often points to underlying medical conditions or emotional stressors.

It’s crucial to maintain a patient and supportive attitude. Identifying the underlying cause can help you and your child find effective solutions.

Nocturnal vs. diurnal enuresis

Bedwetting can further be divided into nocturnal enuresis (nighttime bedwetting) and diurnal enuresis (daytime wetting).

Nocturnal enuresis

Nocturnal enuresis is the most common form of bedwetting. It happens when a child wets the bed during the night due to various reasons (e.g. physiological, developmental or medical factors). Nocturnal enuresis affects millions of children and is more common in boys than girls.

Diurnal enuresis

Diurnal enuresis, or daytime wetting, occurs when a fully potty-trained child has accidents during the day. This type of enuresis is more common in girls than boys. Daytime wetting can be hereditary but is also associated with medical conditions like constipation, urinary tract infections or a delayed sense of the need to urinate.

Causes of bedwetting

The causes of bedwetting vary depending on whether it is primary or secondary.

Causes of primary bedwetting

Primary bedwetting beyond the age of five may be due to:

  • Small or underdeveloped bladder: If a child's bladder is small, it might not hold all the urine produced at night.

  • Poor daytime toilet habits: Children who ignore the urge to wee might develop habits that contribute to bedwetting.

  • Delayed brain-bladder communication: Some children take longer to develop the connection between the brain and bladder, leading to nighttime accidents.

  • Hormonal imbalance: An underproduction of the antidiuretic hormone can cause the body to produce more urine at night.

Causes of secondary bedwetting

Secondary bedwetting often indicates an underlying medical or psychological issue and may occur alongside daytime wetting. Common causes include:

  • Liquid intake: Consuming too much fluid or caffeine before bed can disrupt nighttime routines. Check out our fluid intake dos and don'ts guide.

  • Genetics: Bedwetting often runs in families.

  • Stress: Emotional stressors, such as moving homes, changing schools, the arrival of a sibling or parental conflicts, can affect a child's bladder control.

  • Urinary tract infections (UTIs): UTIs can cause pain during urination and a frequent urge to pee, leading to bedwetting.

Understanding the different types of bedwetting is crucial for addressing the issue effectively. While primary enuresis is generally developmental and often resolves with time, secondary enuresis may require medical or psychological intervention. Maintaining a supportive and patient approach, along with consulting healthcare professionals, can help children overcome bedwetting and build their confidence.

Take the first step towards dry days and nights

Are you ready to help your child overcome bedwetting and regain their confidence? Our clinic specialises in treating children with lower urinary tract dysfunction and we’re here to support you every step of the way. Book a free 15-minute discovery call with Cheryl Jennings, our clinical nurse practitioner in paediatric urology,  to discuss your child's specific needs and learn how we can help.

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