What is bedwetting in children?

Children's bedwetting is not necessarily caused by some diseases. It may be caused by drinking too much water before going to bed and not paying attention to getting up at night to urinate. Of course, if it is caused by a disease, then treatment should also be taken seriously. Bedwetting is closely related to the nervous regulation system, bladder and urethra. If there are problems in these places, it will naturally cause bedwetting.

1. Bedwetting and the neural regulation system - that is, the primary urination center of the cerebral cortex, brainstem and spinal cord, and the pudendal nerve, abdominal nerve, pelvic nerve, sacral nerve, etc. that control the bladder and urethra. Due to delayed functional development of the brain and brainstem, weak control over the primary urination center of the spinal cord, or disorders of the spinal cord and various nerve conduction pathways, enuresis occurs due to loss of bladder and urethra control.

2. Bed-wetting and bladder - Due to delayed development of bladder function, the ability to safely exercise autonomous control cannot be exercised, resulting in uninhibited contractions during the storage period, making the bladder capacity small, sensitive and compliant; the perception ability during bladder filling and contraction periods is not high, and the stimulation intensity to the cerebral cortex is lower than the sleep-wake threshold; the bladder pressure receptors are dysfunctional and cannot provide warning information, etc., causing the patient to urinate before waking up.

3. Bed-wetting and urethra - incomplete urethral closure function, that is, unstable urethra causing enuresis; urethral malformations such as congenital stenosis, etc.

4. Bedwetting and sleep-wake dysfunction - delayed development of sleep-wake function and wake dysfunction are one of the main causes of enuresis. The dysfunction can be caused by incomplete perception of bladder filling and contraction or excessive fatigue leading to deep sleep, or by incomplete urination function or delayed development.

5. Bedwetting is related to decreased secretion of antidiuretic hormone (ADH) - Normal people secrete less ADH during the day than at night (1:2.5), and the urine volume changes in the opposite direction with the secretion of ADH (the ratio of urine volume during the day and at night is about 3-4:1). Some children with enuresis have insufficient secretion of ADH at night (1:1.4), which increases the urine volume at night, produces dilute urine, and increases the burden on the bladder, causing enuresis.

6. Bed-wetting and heredity - About 30-40% of patients with enuresis have a family history. Studies have shown that it is a multi-gene inheritance, and the probability of occurrence varies depending on race and region. Generally, the incidence rate is 77% among children of both parents with enuresis, 44% among children of one parent with enuresis, and only 15% among children of neither parent with enuresis.

7. Bedwetting and mental, psychological and behavioral abnormalities - sudden mental stimulation, such as fear, shock, rage, sadness, strong psychological depression, abnormal behavior, confusion, etc. can all cause bedwetting. These factors can become the cause of persistent and intractable enuresis in children as they grow and in adults.