What causes bedwetting at 15?

Bedwetting is actually a manifestation of a slow or untimely nervous control system. Under normal circumstances, the brain nerves in the body will solve the problem by themselves when they receive the urge to urinate, but for bedwetters, the command has not arrived. For fifteen-year-old teenagers, bedwetting may be the result of many factors. It may be that they have slept too deeply in recent times, or it may be an infection of the urinary tract. The following three reasons are the main causes of bedwetting.

1. Developmental delay of the neuroendocrine system in the brain

(1) Detrusor instability or low-compliance bladder (high sensitivity to urine storage), reduced bladder functional capacity, and the actual amount of urine that can be stored is smaller than normal. Patients often have frequent urination during the day or before bedtime, urgency, and even urinary incontinence.

(2) The bladder filling and contraction sensing function is incomplete, and the bladder filling and contraction fail to wake the patient from sleep.

(3) Incomplete urethral closure function, that is, unstable urethra. It also manifests as frequent urination, urgency, urinary incontinence, etc.

(4) Insufficient secretion of antidiuretic hormone (ADH) from the pituitary gland results in increased urine production at night, exceeding the capacity of the bladder.

2. Sleep Factors

In the early days, it was generally believed that enuresis was caused by deep sleep and high awakening threshold. In fact, enuresis has nothing to do with the depth of sleep, and enuresis does not occur during deep sleep.

A large number of nocturnal continuous EEG studies have shown that:

(1) Arousal dysfunction is an important cause of enuresis. Incomplete bladder filling and contraction perception function and excessive fatigue leading to deep sleep can all lead to arousal dysfunction.

(2) Poor urination control function is more significant after falling asleep, indicating that delayed development of urination control function plays an important role in the occurrence of enuresis.

(3) The sleep cycle of patients with enuresis is in a disordered state, which is more obvious in patients who are often woken up to urinate at night.

3. Mental, psychological and behavioral abnormalities

Enuresis can lead to mental, psychological and behavioral abnormalities in patients, which in turn become one of the reasons for persistent and intractable enuresis in patients, especially older children and adults.

The fear of enuresis and the hope to prevent it by urinating frequently are common psychological factors for this type of patients. Influenced by this psychology, patients still remind themselves to urinate during sleep. The frontal lobe urinary urge center in the brain is therefore highly excited, which increases the sensitivity and contractility of the bladder, and a smaller bladder capacity can produce the urge to urinate. If the brain produces a dream scene that allows urination, the detrusor muscle will receive a vague reinforcement of the urination consciousness, while the urethral sphincter will relax and enuresis will occur, which in turn causes a decrease in the functional capacity of the bladder.