Nocturnal enuresis: basic facts and new horizons.

Nocturnal enuresis in children is quite seldom due to psychological factors. Instead, it is caused by a hereditary delay in maturation of the somatic mechanisms (reduction of nocturnal urine production, relaxation of the bladder during sleeping hours, and a normal arousal to a full bladder) which prevent the child from wetting the bed. Doctors treating bedwetting children have often used an expectant attitude because nocturnal enuresis has been looked upon as self-limiting and innocent. According to recent research, this is not true. In children aged 7 years, more than 5% and in the adult population 0.5% report nocturnal enuresis. Thus, many enuretic children will remain bedwetters for life if left untreated. Furthermore, the child is ashamed and feels guilt because of his nocturnal enuresis which threatens to give a significant impairment of self-esteem at an age when an intact self-image is extremely important for an optimal development of the child's personality. Treatment should be given when the enuretic child wants to sleep dry.