Psychological Aspects of Enuresis in Childhood

Since approximately 10-15% of all children at age six years will have primary monosymptomatic nocturnal enuresis (PMNE) [1], it is a common problem that presents to the general pediatrician and often referred to the urologist or nephrologist. PMNE is defined as bedwetting in children older than age five years without lower urinary tract symptoms or bladder dysfunction [2], and each year 15% of children will outgrow the condition resulting in approximately 1% to 2% of adolescents still suffering from the condition. Nearly all studies addressing PMNE reveal a strong genetic predisposition at rates of familial history as high as 75% [3]. Since the 1990’s, the medical literature has become replete with studies which focus on the psychological, psychosocial, and quality of life issues that are associated with enuresis. Research provides convincing evidence that enuresis is associated with long lasting effects that persist beyond childhood into adolescence and adulthood. Although time constraints can often lead to the inadequate addressing of psychological effects, it is prudent to consider expanding patient visits so time is available to screen for these life-altering concerns. A brief up-to-date literature review of the psychological aspects of enuresis along with suggested behavioral screening tools are provided for clinicians who care for patients with PMNE.