Sleep Enuresis and Waking Enuresis
It usually occurs in parallel with sleep enuresis. Among our enuretics, there were 33 (15.6%), 19 boys and 14 girls, who urinated on the floor in their sleep (either at night or during the day) and in the waking state.
Differences in Waking and Sleep Enuresis
It is not yet clear whether these children differ in any way from those enuretics who wet the floor only in their sleep. However, it seems that children who cannot fully control their bladder even when awake, have an even stronger disposition for enuresis than those who urinate only in their sleep.
Factors Associated with Waking Enuresis
Although we have had a relatively small number of such patients, we still have the impression that some phenomena accumulate in their pathology that speak for our assumption. Thus, more than a third of these patients (13 to 33) were mentally underdeveloped.
In the anamnesis of 12 patients, we learned that they were asphyxiated after delivery, which may also have left some damage to their nervous system. Of the ten children who suffered from encopresis, 3 were in the group of small patients who, in addition to urinating both in their sleep and in the waking state, had a certain functional weakness of the sphincter).
Relationship with Masturbation
Interestingly, intense masturbation (5 girls) was present in 6 children. It may be related in some way to involuntary urination.
Comparison with Literature
It is mentioned in the literature that 5% of enuretics occasionally urinate on the floor only in the waking state (Bakwin). In our material, we encountered only 3 (1.4%) such patients, two girls and one boy. The enuresis of these children is sometimes very close to conscious defiance.
7-year-old Jonny is a very spoiled boy. When the environment does not satisfy him in something, he becomes angry, becomes impudent and aggressive. As educators increasingly resist his arbitrariness, Johnny intensifies his defiance. For the past year, he has been adding another form of aggression to his behavior: when he gets angry, he lets both stool and urine into his pants.
Other Causes of Waking Enuresis
In other cases, waking enuresis is usually an expression of fear, e.g., a child’s trepidation before answering at school. When a child is very excited for any reason, he also urinates easily on the floor. Thus, a 6-year-old girl only urinates when she is very happy about something, when she is impatiently expecting something or laughing a lot. In such cases, we cannot speak of true enuresis, but of increased bladder irritability.