Nocturnal Enuresis

Question 1

What is the definition of enuresis?

Answer 1

Continued wetting in over 5 years for girls and over 6 years for boys.

Question 2

What is the difference between primary and secondary enuresis?

Answer 2

1. Primary - child has never been consistently dry

2. Secondary - actually try for six months which has now been lost

Question 3

What are the major contributing factors to nocturnal enuresis?

Answer 3

Family history, delayed maturation of bladder neurological control, small bladder capacity, low levels of ADH.

Question 4

What should you roll out in a presentation of nocturnal enuresis?

Answer 4

UTI, DM, constipation, epilepsy

MRI - abnormal neurology of lower limbs

Question 5

How is nocturnal enuresis diagnosed?

Answer 5

1. Frequency and pattern of bed-wetting
2. Any daytime symptoms
3. Associated symptoms such as constipation
4. Child’s usual drinking and toilet habits

Question 6

What is the management for nocturnal enuresis?

Answer 6

1. Reassure family and child that the problem is common
2. Restrict fluids before bed
3. Star chats celebrate each dry night (positive reinforcement)
4. Bed wetting alarm with moisture sensitive pad
5. Desmopressin for children over 7-years old for short-term control