Day and night time wetting Flashcards
What is enuresis?
Involuntary urination
What is enuresis?
Involuntary urination
Nocturnal vs diurnal enuresis
Nocturnal - at night
Diurnal - during day
What is normal stages of childhood to control nocturnal vs diurnal enuresis?
Under 5 both considered normal
Most children control dirunal enuresis by 3-4 years old
What is primary nocturnal enuresis
Child never managed to be dry at nigth
What is the most common cause of primary nocturnal enuresis
Variation on average development esp under 5 years
FH of delayed dry nights
What is the most common cause of primary nocturnal enuresis
Variation on average development esp under 5 years
FH of delayed dry nights
Reassurnance will resolve
Other causes of primary enuresis
Overactive bladder
Fluid intake
Failure to wake
Secondary
What is an overactive bladder?
Frequent small volume urination prevents the development of bladder capacity
What can have an espeically diuretic effect at bedtime?
Fizzy drinks, juice, caffeine
What causes failure to wake to wee?
Due to particuarly deep sleep and underdeveloped bladder signals
Secondary causes of primary enuresis
Chronic constipation, UTI, learning disability or cerebral palsy
What is the initial management of primary nocturnal enuresis?
Establish underlying cause by keeping a 2 week diary of toileting, fluid intake and bedwetting episodes
Establish patterns and areas for change
Management of primary nocturnal enuresis
Reassure if under 5 that will resolve
Lifestyle chagnes
Encouragement and positive reinforcement
Underlying/exacerbating factors eg constipation
Enuresis alarms
Pharmacological
Lifestyle changes for primary enuresis
reduced fluid intake in the evenings, pass urine before bed and ensure easy access
