Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about Enurias.

And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash enuresis

or in the renal and urology section of the Zero Defininals pediatrics book. So let's get straight into it.

The term enuresis is used to describe involuntary urination. Bedwetting is called nocturnal enuresis.

The inability to control the bladder function during the day is called diurnal enuresis.

Most children get control of daytime urination by age two years and night time urination by three to four

years. Firstly, let's talk about primary nocturnal enuresis. And primary nocturnal enuritis is where the child has never managed to be consistently dry at night time.

The most common cause of primary nocturnal enuriasis is a variation on normal development,

particularly if the child is younger than five years.

Often patients will have a family history of delayed dry nights.

In this situation, reassurance is important and there's no need to jump to further investigations or management.

There are a number of causes of primary nocturnal enuresis and these include an overactive bladder.

An overactive bladder can occur where frequent small volume

urination prevents the development of a good bladder capacity. Another cause is fluid

intake prior to bedtime, particularly fizzy drinks, juice and caffeine which can have a

diuretic effect. Failure to wake up can be another cause,

particularly due to deep sleep and underdeveloped bladder signals.

Psychological distress can contribute, for example, a low self-esteem,

too much pressure or stress at home or school.

And there can be secondary causes such as chronic constipation, urinary tract infection, learning disability and cerebral palsy.

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