Bed-wetting, or the involuntary passage of urine at night. It can occur at all ages but is a particular problem with children and the elderly. In general, paediatricians prefer not to treat enuresis much before the age of six, as it may be a normal phenomenon which will stop as the child grows older. However, when the condition persists, the child and parents need advice. Treatment is by positive reinforcement of bladder control, alarm systems such as the ‘pad and bell’, or occasionally by drugs such as desmopressin, which reduces night-time urinary output. Some children have an ‘irritable bladder’ and can be helped by drugs which relieve this. Enuresis is often a result of psychological disturbance, particularly where family relationships are disrupted. In this circumstance medication is unlikely to be effective.

Constipation is a common cause of urinary incontinence – and hence bed-wetting –and treatment may help. Enuresis in the elderly may also be due to organic disease or to mental deterioration and confusion. Appropriate investigation, treatment and nursing should be arranged. (See NOCTURNAL ENURESIS.)