aetiological factors
Last reviewed 04/2022
Causes of enuresis include:
- genetic predisposition - about 70% of affected children have a first-degree relative who was enuretic - linkage studies have localised a genetic predisposition to this condition to chromosome 13q (1)
- urinary tract infection - about 5% of enuretic children have urinary infections, compared with 1% of other children of comparable age. The relationship is not necessarily causal; persistent enuresis may predispose to an ascending infection
- bladder capacity - may be smaller than normal. Constipation or cystitis also may lead to reduced bladder capacity (2)
- stress - enuresis sometimes worsens or starts after a stressful event
- polyuria may be the result of:
- diabetes mellitus
- diabetes insipidus
- chronic renal failure
- structural urinary tract abnormalities:
- ectopic ureter
- ectopia vesicae
- urethral valves
- epispadias
- neurogenic bladder:
- meningomyelocoele
- spinal dysraphism
- spinal cord tumour
- impaired nighttime arousal due to sleep-disordered breathing
- medications (2):
- valproic acid
- clozapine
- SSRIs
Reference:
- (1) Prescriber (2001), 12 (5), 103-8.
- (2) Robson WL. Evaluation and management of enuresis. N Engl J Med. 2009;360(14):1429-36.
urinary tract infection (UTI) in children