Differential Diagnosis for 16 Year Old Male Bedwetting

• Single Most Likely Diagnosis

  • Primary Nocturnal Enuresis: This condition is the most common cause of bedwetting in adolescents. It is characterized by the involuntary urination during sleep in individuals who are beyond the age where nocturnal bladder control typically occurs. The exact cause is often unknown, but it can be related to factors such as genetics, bladder control issues, or the production of antidiuretic hormone (ADH) which helps regulate urine production at night.

• Other Likely Diagnoses

  • Secondary Nocturnal Enuresis: This occurs when an individual who has previously achieved nocturnal continence begins to experience bedwetting again. It can be due to various factors such as urinary tract infections, diabetes, or neurological disorders affecting bladder control.
  • Sleep Disorders: Certain sleep disorders like sleep apnea or restless leg syndrome can increase the likelihood of bedwetting by affecting the normal sleep pattern and potentially leading to a fuller bladder or reduced awareness of the need to urinate.
  • Polyuria: Conditions that lead to the production of an excessive amount of urine, such as diabetes insipidus or uncontrolled diabetes mellitus, can cause bedwetting.

• Do Not Miss Diagnoses

  • Diabetes Mellitus: Uncontrolled diabetes can lead to polyuria (excessive urine production), which in turn can cause bedwetting. It's crucial to diagnose and manage diabetes to prevent long-term complications.
  • Urinary Tract Infections (UTIs): UTIs can cause irritation to the bladder, leading to a frequent and urgent need to urinate, which might result in bedwetting if the individual cannot wake up in time to use the bathroom.
  • Neurological Disorders: Conditions such as spina bifida, spinal cord injuries, or multiple sclerosis can affect the nerves that control the bladder, leading to incontinence.

• Rare Diagnoses

  • Nocturnal Seizures: In some cases, seizures that occur during sleep can cause loss of bladder control, leading to bedwetting. This would be a rare cause but is important to consider, especially if there are other signs of seizure activity.
  • Genetic Disorders: Certain genetic conditions can affect bladder control or increase the risk of sleep disorders that might lead to bedwetting. Examples include conditions that affect the development or function of the brain and nervous system.