Enuresis Flashcards
What is enuresis
Describes involuntary urination
What is primary nocturnal enuresis
Where the child has never managed to consistently dry at night
Commonest cause of primary nocturnal enuresis
Variation of normal development, especially if child is under 5. Usual Fhx
Other causes of primary nocturnal enuresis
Overactive bladder, fluid intake, failure to wake, psychological distress, secondary causes such as chronic constipation, UTI, learning disability and cerebral palsy
Management of primary nocturnal enuresis
Reassure parents likely to resolve, lifestyles changes, 2 week diary, positive reinforcement, treat underlying causes, enuresis alarm and lastly pharmacological treatment
What is secondary nocturnal enuresis
When the child begins betwetting when they have previously been dry for at least 6 months.
Causes of secondary nocturnal enuresis
UTI, constipation, type 1 diabetes, new psychosocial problems, maltreatment
Two main types of incontinence causing diurnal enuresis
Urge incontinence and stress incontinence
What is urge incontinence
Overactive bladder with little warning
What is stress incontinence
Leakage of urine during physical exertion, coughing or laughing
Other causes of diurnal enuresis
Recurrent UTIs, psychosocial problems, constipation
Pharmacological treatment for enuresis
Desmopressin - reduces volume of urine produced by kidneys (vasopressin).
Oxybutinin - anticholinergic reducing contractility of bladder.
Imipramine - TCA, may help relax bladder and lighten sleep
