Nocturnal enuresis

Question 1

Child with short history of nocturnal enuresis. State two differentials for systemic illness that could be causing this presentation

Answer 1

UTI
Constipation
Diabetes
Lower limb weakness
Obstructive sleep apnoea

Question 2

List two red flags for nocturnal enuresis

Answer 2

symptoms of systemic illness
lower limb weakness
safeguarding issues
unexplained secondary enuresis

Question 3

What is the initial advice for nocturnal enuresis?

Answer 3

Fluid intake advice- time, amount, encourage toilet use
Reward systems- reward for agreed behaviors rather than dry nights

Question 4

What is the first line and second line options for nocturnal enuresis?

Answer 4

1st- Alarm setting- alarm every night, both parents and child get up to urinate
2nd- Drug treatment

Question 5

If alarm system has failed after three months, what is the drug treatment available?

Answer 5

oral desmopressin