Enuresis
1 medicine
Enuresis is involuntary urination, most commonly bedwetting in children, that often responds to behavioural steps and can be helped by medicine such as imipramine.
Key facts
- Enuresis means involuntary urination during sleep or waking hours; in children it is usually called bedwetting, affecting roughly 15% of five-year-olds and 1 to 2% of teenagers.
- Causes vary by age: delayed bladder maturation, deep sleep patterns, a smaller bladder capacity, or lower nighttime levels of the hormone that concentrates urine. Stress, constipation, and urinary tract infections can trigger or worsen episodes.
- Behavioural approaches come first, especially moisture alarms. When more help is needed, imipramine, a tricyclic from the antidepressants class, can reduce nocturnal wetting.
- Bedwetting that starts suddenly after at least six dry months, or returns in an older child or adult who was previously dry, is worth a doctor's review.
What causes it
The causes vary by age. In younger children, delayed bladder maturation and deep sleep patterns are the main factors: a smaller bladder capacity, reduced nighttime production of the hormone that concentrates urine (ADH), or simply not waking to a full-bladder signal all play a part. Stress, constipation, and urinary tract infections can trigger or worsen episodes at any age. Secondary enuresis, bedwetting that returns after at least six dry months, warrants a check for an underlying cause such as diabetes or a sleep disorder.
Treatment options
Behavioural approaches come first: moisture alarms are the most evidence-backed method, alongside fluid restriction in the evening and timed voiding routines. When these are not enough, or where a short-term solution is needed, such as before a school trip, medicine can help. Imipramine, a tricyclic from the antidepressants class, has been used for decades to reduce nocturnal wetting: it lowers bladder contractility and alters sleep arousal. Response rates are reasonable, though relapse after stopping is common, so it tends to work best as a bridge alongside behavioural strategies rather than a standalone fix.
When to see a doctor
Most bedwetting resolves on its own and rarely needs urgent attention. Still, get a doctor's review if bedwetting starts suddenly in an older child or adult who was previously dry, or if it comes with pain, unusual thirst, or daytime urinary symptoms, since these can point to a condition that needs its own treatment.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.