Enuresis in children

A case-based approach

Drew C. Baird, Dean Seehusen, David V. Bode

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Enuresis is defined as intermittent urinary incontinence during sleep in a child at least five years of age. Approximately 5% to 10% of all seven-year-olds have enuresis, and an estimated 5 to 7 million children in the United States have enuresis. The pathophysiology of primary nocturnal enuresis involves the inability to awaken from sleep in response to a full bladder, coupled with excessive nighttime urine production or a decreased functional capacity of the bladder. Initial evaluation should include a history, physical examination, and urinalysis. Several conditions, such as constipation, obstructive sleep apnea, diabetes mellitus, diabetes insipidus, chronic kidney disease, and psychiatric disorders, are associated with enuresis. If identified, these conditions should be evaluated and treated. Treatment of primary monosymptomatic enuresis (i.e., the only symptom is nocturnal bed-wetting in a child who has never been dry) begins with counseling the child and parents on effective behavioral modifications. First-line treatments for enuresis include bed alarm therapy and desmopressin. The choice of therapy is based on the child’s age and nighttime voiding patterns, and the desires of the child and family. Referral to a pediatric urologist is indicated for children with primary enuresis refractory to standard and combination therapies, and for children with some secondary causes of enuresis, including urinary tract malformations, recurrent urinary tract infections, or neurologic disorders.

Original languageEnglish (US)
Pages (from-to)560-568
Number of pages9
JournalAmerican family physician
Volume90
Issue number8
StatePublished - Oct 15 2014
Externally publishedYes

Fingerprint

Enuresis
Sleep
Urinary Bladder
Nocturnal Enuresis
Therapeutics
Deamino Arginine Vasopressin
Diabetes Insipidus
Urinalysis
Urinary Incontinence
Obstructive Sleep Apnea
Constipation
Nervous System Diseases
Urinary Tract
Chronic Renal Insufficiency
Urinary Tract Infections
Physical Examination
Psychiatry
Counseling
Diabetes Mellitus
Referral and Consultation

ASJC Scopus subject areas

  • Family Practice

Cite this

Baird, D. C., Seehusen, D., & Bode, D. V. (2014). Enuresis in children: A case-based approach. American family physician, 90(8), 560-568.

Enuresis in children : A case-based approach. / Baird, Drew C.; Seehusen, Dean; Bode, David V.

In: American family physician, Vol. 90, No. 8, 15.10.2014, p. 560-568.

Research output: Contribution to journalArticle

Baird, DC, Seehusen, D & Bode, DV 2014, 'Enuresis in children: A case-based approach', American family physician, vol. 90, no. 8, pp. 560-568.
Baird, Drew C. ; Seehusen, Dean ; Bode, David V. / Enuresis in children : A case-based approach. In: American family physician. 2014 ; Vol. 90, No. 8. pp. 560-568.
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