Enuresis is involuntary urination (peeing) beyond the age of anticipated urinary control. It may include nighttime wetting, like bedwetting, and/or daytime wetting. The wetting can occur frequently or rarely. There are possible structural or neurological disorders that can result in a child wetting, but usually involuntary peeing is the result of a functional disorder (a condition where a bodily function is impaired without a structural or anatomical cause).
What causes bedwetting?
Bedwetting is a common problem in kids, especially children under the age of 6 years. In fact, according to the American Academy of Pediatrics, most children do not become fully toilet trained until they are between 2 and 4 years of age. About 13% of 6-year-olds wet the bed, while about 5% of 10-year-olds do.
No one knows for sure what causes bedwetting or why it stops, but it’s usually a natural part of development and not a sign of any deeper medical or emotional issues. Bedwetting often runs in families: kids who wet the bed often have a relative who did, too. If both parents wet the bed when they were young, it's very likely that their child will, but most children grow out of it.
Bedwetting usually goes away by itself, but until it does, it can be embarrassing and uncomfortable for your child. It’s important to be sensitive to your child’s feelings about bedwetting and provide support and positive reinforcement.
When to See a Doctor about Enuresis
Bedwetting that begins abruptly or is accompanied by other symptoms can be a sign of another medical condition, so be sure to call a doctor if your child has any of these:
suddenly starts wetting the bed after being consistently dry
for at least 6 months
begins to wet his or her pants during the day
starts misbehaving at school or at home
complains of a burning sensation or pain when urinating
has to urinate frequently
is drinking or eating much more than usual
has swelling of the feet or ankles
is still wetting the bed at age 7 years
Nocturnal Enuresis (Nighttime Wetting)
Wetting at night after the age of 4 years old may be related to a relative immaturity of how the body controls urine production at night. During sleep a hormone (vasopressin) helps reduce urine production and in some children, not enough of this hormone is released at night. Commonly, these children can be very heavy sleepers and not recognize that their bladder is full and they need to wake up.
Diurnal Enuresis (Daytime Wetting)
Wetting that occurs involuntarily during the day may be caused by a voiding dysfunction such as:
Overactive Bladder (Urge syndrome) is associated with frequent episodes of urgency and small bladder capacity (found in two-thirds to three- quarters of children with daytime wetting)
Dysfunctional Voiding is related to how the bladder muscles work (there may also be an increased risk of urinary tract infections and constipation)
Dysfunctional elimination syndrome includes both significant constipation along with involuntary wetting
Other conditions like Giggle incontinence (peeing with laughing, sneezing, or coughing) and Vaginal Reflux (urine caught in the vagina) may cause daytime wetting
How is Enuresis treated?
Our medical team will first evaluate your child for conditions like a bladder infection, an anatomical problem, or a neurological disorder. If none are found, then we may consider therapy that includes committing to a home management plan to help monitor your child’s progress and behaviors, as well as keeping a bladder/bowel daily diary. It may take some time to see improvement, but we will be with you and your child every step of the way, providing gentle, compassionate support.
A urine protein test measures the total amount of protein in the urine. Once a urine sample is collected, the lab determines the amount of protein in the urine sample. This test is often done as part of a routine urinalysis in which several chemicals in the urine are measured.
Why It's Done
In most healthy people, the kidneys prevent significant amounts of protein from entering the urine (pee), so the urine protein test is most commonly used to screen for kidney disease. It's also used to monitor kidney function in kids already diagnosed with kidney disease or who are taking medicines that can affect the kidneys.
Abnormal results also may point to diseases affecting other parts of the body. Other tests may be needed before a definite diagnosis can be made.
Before the test, your child might need to temporarily stop taking specific drugs that could interfere with results. Be sure to discuss this with your doctor.
Collecting the specimen should only take a few minutes. Your child will be asked to pee into a clean sample cup in the doctor's office. If your child isn't potty trained and can't pee into a cup, a small catheter may need to be inserted into the bladder to get the urine specimen.
Alternatively, a urine collection bag with adhesive tape on one end might be used to collect a sample from an infant. You'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, you'll secure it with the attached tape. You can then put a diaper on your baby. Remove the collection bag once your baby has peed into it, usually within an hour. Bring this specimen to the lab.
Sometimes it's better to collect a sample first thing in the morning after your child wakes up. If this is the case, you may be asked to help your child with the test at home. Follow any storage and transportation instructions the lab gives you.
What to Expect
Because the test involves normal urination, there shouldn't be any discomfort as long as your child can provide a urine sample.
Getting the Results
The results of the urine protein test should be available within a day. Your doctor will go over the results with you and explain what they mean. If the results are abnormal, more tests may be ordered.
No risks are involved when taking a urine protein test. The adhesive tape on the collection bag may occasionally irritate an infant’s skin. If a catheter is used to obtain the urine, it may cause temporary discomfort. If you have any questions or concerns about this procedure, talk to your doctor.
Helping Your Child
The urine protein test is painless. Explaining how the test will be conducted and why it's being done can help ease any fear. Make sure your child understands that there should be no other objects, such as toilet paper or hair, in the sample.
If You Have Questions
If you have questions about the urine protein test, speak with your doctor.
Reviewed by: Rupal Christine Gupta, MD
Date reviewed: August 11, 2016