Familial Adult Nocturnal Enuresis – Weeping Bladder through Generations

Abstract Nocturnal enuresis (NE) is defined as the inability to hold urine through the night. It is physiological up to 5 years of age, beyond which it is considered abnormal. In adults, the prevalence of adult primary NE ranges from 0.5% to 2%, and there is a gender shift from male to female predominance. The frequency of bedwetting tends to reduce with an increase in age. A 23-year-old female patient reported with depressive symptoms for 3 months. She had NE since childhood persisting into adulthood, which led to severe marital discord. There was a significant family history, with both her parents and her paternal grandfather with adult NE, suggesting a strong genetic predisposition. She was treated with behavioral therapy along with imipramine and selective serotonin reuptake inhibitors. Patients with NE are found to have a higher incidence of psychiatric comorbidities. They also report lower self-esteem and significant psychosocial impairment. NE exhibits an autosomal dominant mode of transmission with high penetrance. The few chromosomes associated with NE are chromosome 22, 13, and 6. Management is essentially lifestyle modification and behavioral therapy. The pharmacological agents used are desmopressin and anticholinergics.