NEW YORK (Reuters Health) - A delay in the maturation of the brain-bladder connection may underlie problem bed-wetting in some children, according to UK researchers.

They emphasize that such a delay, if it occurs, is not a "major developmental problem." Instead, it may be that in some children who persistently wet the bed, the "pathways" between the brain and bladder are not yet fully mature, Dr. Philip C. Holland told Reuters Health.

Holland, of Leeds General Infirmary, led a new study in which school-age children with chronic nighttime bed-wetting--or primary nocturnal enuresis--took a standard drawing test designed to gauge neurological development.

In addition, the researchers looked at the children's response to treatment with an artificial form of vasopressin, a hormone released by the brain's pituitary gland that normally decreases urine output. Some research has shown that chronic bed-wetters may fail to have the nightly increase in vasopressin that occurs in most people, and the synthetic form--known as desmopressin--is sometimes used as a treatment.

Holland's team found that among the 34 children they studied, those who had not responded to desmopressin made more errors on the drawing tasks. And no child who made three or more errors was helped by the hormone treatment, according to findings published in the September issue of Archives of Disease in Childhood.

"We are suggesting that children who make errors on the...test have more wrong than simply a failure to produce vasopressin at night," Holland said. "The neurological pathways between the brain and bladder are not fully mature."

Bed-wetting is so common among preschool children, it is not considered a concern. By school-age, it becomes much less prevalent, with about 5% of 7-year-olds still repeatedly wetting the bed. Most children "outgrow" the problem without treatment.

The exact causes of chronic bed-wetting in older children are not fully clear, although family history appears to be important. Similarly, Holland noted, the factors that affect the maturation of the brain-bladder connection are unclear.

However, he and his colleagues note, some research has tied low birth weight to the odds of problem bed-wetting--which they say also suggests that developmental delay may be involved.

And, Holland said, there is some evidence that breast-fed babies are less likely to have persistent bed-wetting as children.

SOURCE: Archives of Disease in Childhood 2002;87:188-191.

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".