Dr. Harel on potential causes of nocturnal enuresis

In this video, Miriam Harel, MD, discusses causes of nocturnal enuresis. Harel is an assistant professor of urology at Albert Einstein College of Medicine, Bronx, New York.

Transcription:

Could you describe your clinical practice?

I think our whole department here provides a pretty comprehensive spectrum of pediatric urologic care. For me personally, I would say my particular interests are in reconstructive surgery, complex hypospadias repair, management of neurogenic and non-neurogenic voiding dysfunction, prenatal hydronephrosis, and I'm also very interested in posterior urethral valves.

What are some potential causes of nocturnal enuresis?

This is a very common condition that we treat and I think it's important to differentiate primary nocturnal enuresis, which means that the children have always had bedwetting and never grew out of it. Another important distinction is whether they have isolated nocturnal enuresis or if they have daytime incontinence as well. Probably the most common scenario that we get a lot of parental concerns about are the patients that only have bedwetting, and it just never went away. And in that particular group, it's first important to reassure parents that in most cases, it's actually normal. There are some genetic factors involved, meaning that some people are just more prone to having this prolonged bedwetting, but for most children, they will just outgrow it over time. That's a very common scenario. Other factors that might come to play are their bladder capacity being small, potentially urine overproduction at night. Some other things that we are always focusing on are any potential daytime habits related to their voiding or bowel movements that can affect them at night. And then another possible source is related to sleep patterns. Arousal can be an issue, most of these children sleep very deeply, andthat can also come into play where as they get older, and their sleep patterns change, they may be more likely to grow out of bedwetting.

This transcription was edited for clarity.