Voiding Disorders

Question 1

Management of enuresis

Answer 1

1.motivational Therapy: star chart
2. Conditioning therapy: alarms
3.pharmacologic therapy
. Desmopressin: reduce urine at night
. Anticholinergics: for overactive bladder
. Tricyclic Antidepressants: Imipramine
4. Biofeedback therapy: teach to controp muscle groups

Question 2

Most common causes of nocturnal enuresis

Answer 2

Nocturnal polyuria (ADH!)
Overactive bladder
Increased arousal threshold

Question 3

Mechanism of urine storage in the bladder in the fetus

Answer 3

sympathetic and pudendal nerve-mediated 
 inhibition of detrusor + closure of the bladder neck and 
proximal urethra (external sphincter)

Question 4

What is the average capacity of a bladder of a neonate

Answer 4

30 mls increasing by 30/y for 8 yrs

Question 5

A neonate bladder carries 30 mls of urine, how much urine can a child of 6 years carry?

Answer 5

Y = 30 + 30 X,
• where Y = capacity in ml and X = age in years

So 30+ (30 x 6) =210 mls