Nocturnal enuresis Flashcards
What is nocturnal enuresis?
Bed wetting at night
When is nocturnal enuresis normal until?
Until 5 years old
What is the epidemiology of nocturnal enuresis?
More common in boys
Strong family history in 2/3 of cases
Common secondary to trauma
What is primary nocturnal enuresis?
Nocturnal enuresis in a child who has never achieved urinary continence overnight
What is secondary nocturnal enuresis?
Nocturnal enuresis in a child who has previously achieved urinary continence overnight
Name 3 organic causes of secondary nocturnal enuresis.
Diabetes
Constipation
UTI
What investigations are used to diagnose nocturnal enuresis?
Urine dip
Full history and examination
Urine osmolality
Renal ultrasound
How should nocturnal enuresis be explained to the child and parents?
It is very common
The child should not be blamed in any way
What are the management options for nocturnal enuresis?
Star charts
Nocturesis alarm
Treat underlying cause
Lifestyle changes - drink less fluid before bed, go to the toilet before bed
What is a star chart?
A chart that rewards the behaviour of a child with a sticker or a star
What is a nocturesis alarm?
An alarm that detects water in the underwear, prompting the child to wake up and go to the toilet
What drug can be trialled in children over 7?
Synthetic ADH (DDVAP)
