Nocturnal enuresis – nighttime bedwetting – is an extremely common problem of childhood. Between 13 – 15% of 6 year olds (up to one in six) wet at least twice a month, many of them really doing so most nights. Even without any treatment this gradually improves, getting less frequent with age. Approximately 15% of kids who bedwet spontaneously “outgrow” it each year, until the percentage still doing it by late adolescence is tiny. Enuresis often runs in families. While it occurs frequently in both sexes, it is somewhat more common in boys.

Generally nocturnal enuresis is NOT a sign of either “psychological” or “organic” illness. Instead it is a functional, developmental phenomenon. In the rare cases when this isn’t true other symptoms, behavioral or physical, are usually present. T hus the only medical workup usually recommended is a good history (including questions about development & behavior), physical exam (including genital exam), and a simple urinalysis with culture. If this process turns up no “red flags”, there is no need to go further in pursuit of pathology. On the other hand, daytime (“diurnal”) enuresis increases the chances of a physical problem considerably. While some children do have both nocturnal & diurnal enuresis for the same non-physical reasons – the presence of daytime wetting would make me more eager to get some radiologic studies looking at urinary tract anatomy and function. These might include a renal ultrasound, a voiding cystourethragram (VCUG), and, occasionally, urodynamics.