To the Editor.—Bakwin overlooks certain dimensions of the subjects he discusses in his paper "Enuresis in Twins" (Amer J Dis Child121:222-225, 1971) which if considered, may illuminate the darker side of the problem.
Alert to heredity in enuresis, Bakwin does not consider that genetic factors may be mediated through an inherited sleeping pattern (deep sleep) and an inherited anatomical feature (stenotic meatus). The enuretic subject and parent who was enuretic in childhood are almost invariably described as deep sleepers; twins and siblings may have similar urethras as well as faces; and we have examples of siblings with stenotic meatuses: the deep sleepers tend to be enuretic, the light sleepers nocturic.
Cognizant that many adults hesitate to admit they were enuretic in childhood Bakwin does not ponder that many mothers may hesitate to admit that their child wets the bed—particularly mothers who prize cleanliness, who are
ARNOLD SJ. ENURESIS. Am J Dis Child. 1972;123(1):84. doi:10.1001/archpedi.1972.02110070134025