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Aetiological factors

Authoring team

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:


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