-IBIS-1.5.0-
tx
urinary system
enuresis
diagnoses

definition and etiology

definition:
Involuntary urination only at night during sleep in a child beyond the age when normal urinary control is typically acquired (4-6 years old). Also called "bed-wetting".

etiology:
• Primary enuresis is the term for when the child has never achieved control of his/her urination, and is the main cause of enuresis in children under 5 years old. A common cause is a small bladder size.
• Secondary enuresis is the term used when the child had complete bladder control and then lost it, mostly occurring in children older than 5 years old. This is frequently tied to psychological problems or organic lesions. Enuresis occurs more frequently in boys and has a familial component.

signs and symptoms

signs and symptoms:
• Loss of urine at night during sleep.
• The physical exam is typically unremarkable.

lab findings:
In child over 3 years old:
• UA.
• Urine culture.

In children over 5 years old: who do not respond to bladder stretching exercises:
• IVP.
• Voiding urethrocystogram.

course and prognosis

In general, with patience and treatment, the prognosis is quite good. Children with primary enuresis will eventually outgrow it, even without therapy. In cases of secondary enuresis, the prognosis depends on the etiology.

differential diagnosis

• Diabetes mellitus.
• Urinary tract infection.
• Anatomic lesion or obstruction in the urinary tract.
• Epilepsy.
• Psychological disorders.
• Food allergies.


footnotes