Primary enuresis -- bedwetting since infancy; and
Secondary enuresis -- wetting developed after being continually dry for a minimum of six months.
What is primary bedwetting ?
Primary bedwetting is generally viewed as a delay in maturation of the nervous system. At 5 years of age, approximately 20% of children wet the bed at least once a month with about 5% of males and 1% of females wetting nightly. By 6 years of age, only about 10% of children are bedwetters -- the large majority being boys. The percentage of all children who are bedwetters continues to diminish by 50% each year after 5 years of age. Family history plays a big roll in predicting primary bedwetting. If one parent was a bedwetter, the offspring have a 45% chance of a developing primary enuresis as well.
What causes secondary bedwetting ?
Urinary tract infections, metabolic disorders (for example, various types of diabetes), external pressure on the bladder (for example, extreme constipation by a large rectal stool mass), as well as neurologic disorders of the spinal cord must be considered among the causes of secondary bedwetting.
How is the cause of secondary bedwetting diagnosed ?
Generally, a complete history and thorough physical exam provide the initial evaluation of a child with primary bedwetting. A urinalysis and urine culture generally complete the workup. Further laboratory and radiological studies are usually reserved for the youngster who presents with secondary bedwetting.
