Hovland- Elimination Disorders

Question 1

What is enuresis?

Answer 1

Repeated voiding of urine into bed or clothes (can be voluntary or intentional)

• significant if it occurs at least twice a week for at least 3 consecutive months
• age at least 5 yrs
• not attributed to medical condition

Question 2

What are subtypes of enuresis?

Answer 2

Nocturnal- most common, voiding occurs during 3rd sleep cycle
Diurnal-urinary incontinence (disruptive behavior, social fears)
1. urge incontinence-detrusor muscle
2. voiding postponement-defer micturition until incontinent

Question 3

What is the prevalence of enuresis?

Answer 3

5-20% of children age 5

Males > Females

Question 4

What is the difference between primary and secondary enuresis?

Answer 4

primary-continence never established

secondary- continence established then lost

Question 5

What is the prognosis of enuresis?

Answer 5

• best predictor is number of first degree relatives w/ bedwetting problems
• factors: lax toilet training, psychosocial stress, child abuse

Question 6

What is the treatment for enuresis?

Answer 6

• positive role modeling
• increase fluids
• urine alarms
• meds: imipramine/desmopressin

Question 7

What are behavioral interventions for enuresis?

Answer 7

1. Retention control training- increase functional bladder capacity
2. Sphincter control exercises- start and stop flow of urine

Question 8

What is encopresis?

Answer 8

Repeated passage of feces into inappropriate places (clothing/floor)–can be voluntary or intentional

• at least 1 event each month for 3 months
• at least 4 years of age
• not d/t physiological effects

Question 9

What is the prevalence of encopresis?

Answer 9

1% of 5 year olds

boys> girls

Question 10

What is the treatment for encopresis?

Answer 10

Behavior therapy

1. clean out bowel
2. laxative regimen
3. monitor fiber
4. reduce suppositores
5. routine
6. reward success