Urinary incontinence in children

Dtsch Arztebl Int. 2011 Sep;108(37):613-20. doi: 10.3238/arztebl.2011.0613. Epub 2011 Sep 16.


Background: Urinary incontinence (bedwetting, enuresis) is the commonest urinary symptom in children and adolescents and can lead to major distress for the affected children and their parents. Physiological and non-physiological types of urinary incontinence are sometimes hard to tell apart in this age group.

Methods: This article is based on selected literature retrieved by a PubMed search and on an interdisciplinary expert consensus.

Results and conclusion: Nocturnal enuresis has a variety of causes. The main causative factors in monosymptomatic enuresis nocturna (MEN) are an impaired ability to wake up when the bladder is full, due to impaired or absent perception of fullness during sleep, and an imbalance between bladder capacity and nocturnal urine production. On the other hand, non-monosymptomatic enuresis nocturna (non-MEN) is usually traceable to bladder dysfunction, which is also the main cause of diurnal incontinence. A basic battery of non-invasive diagnostic tests usually suffices to determine which type of incontinence is present. Further and more specific testing is indicated if an organic cause is suspected or if the treatment fails. The mainstay of treatment is urotherapy (all non-surgical and non-pharmacological therapeutic modalities). Some patients, however, will need supportive medication in addition. Urinary incontinence has different causes in children and adults and must therefore be diagnosed and treated differently as well. All physicians who treat the affected children (not just pediatricians and family doctors, but also pediatric nephrologists, urologists, pediatric surgeons, and child psychiatrists) must be aware of the specific features of urinary incontinence in childhood.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Antidiuretic Agents / therapeutic use
  • Behavior Therapy
  • Benzilates / therapeutic use
  • Child
  • Deamino Arginine Vasopressin / therapeutic use
  • Diagnosis, Differential
  • Diurnal Enuresis / classification
  • Diurnal Enuresis / etiology*
  • Diurnal Enuresis / therapy
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Nocturnal Enuresis / classification
  • Nocturnal Enuresis / etiology*
  • Nocturnal Enuresis / therapy
  • Parasympatholytics / therapeutic use
  • Practice Guidelines as Topic
  • Urodynamics / physiology


  • Antidiuretic Agents
  • Benzilates
  • Parasympatholytics
  • propiverine
  • Deamino Arginine Vasopressin