Impact on parents
In a population based study by Foxman 19861, 17% worried a great deal and 46% some or a little. Most mothers worry about the welfare of their child. In another study by Butler et al 19862, the greatest maternal concerns (on a scale from 1 to 7) were:
Parents also believe that their child should become dry at a very early age: the mean anticipated age of dryness was 3.18 years in one study by Haque et al 19813. The causes that parents believed to be responsible for their child's wetting were emotional problems 35.5%, heavy sleeping 38.2%, physical problem 21.4%, familial problem 28.9%, small bladder 10.7%3.
A minority of mothers show an attitude described as "maternal intolerance" by Butler et al 19862. These mothers are convinced that their child is wetting on purpose. They believe the child is able to control the bedwetting, they get angry with their child, do not invest energy in treatment and withdraw and even punish their child.
Frequent follow-up and emotional support and encouragement appear to be important components of an efficacious intervention for children with night-time bedwetting2. Caring for wetting children and their parents is of great help – even if, or especially when the treatment is not as successful as everyone (including doctors and nurses) would wish.
Fortunately, the majority of parents are primarily concerned about the emotional and social effects of bedwetting on their child4.
Is a small bladder capacity a cause of bedwetting?
There is certainly some evidence that the bladder muscles are not properly relaxed during sleep in some individuals with primary night-time bedwetting5. This leads to a decreased bladder capacity and earlier initiation of the micturition reflex. The balance between bladder capacity and nocturnal urine production is important in determining the onset of an enuretic event6. If nocturnal urine production in children is higher than the bladder capacity bedwetting will occur. A study by Vande Walle7 provides evidence of the balance between urine volume and the bladder volume. He further relates the imbalance to the age of the child and suggests it is an immaturity of the mechanism for this balance which leads to bedwetting. The mechanism usually matures during the ages of 2 to 5. However in some subjects this maturation is delayed and results in nocturnal polyuria and bedwetting.1