Enuresis

Cody B. Godfrey, DO and Swati Avashia, MD, FAAP, FACP, ABIHM Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Classification

    • ▪ Primary nocturnal enuresis (NE): 80% of all cases; child/adult who has never established urinary continence on consecutive nights for a period of ≥6 months
    • ▪ Secondary...

DIAGNOSIS

HISTORY

  • Age of onset, duration, severity

  • LUT tract symptoms

  • Constipation and encopresis (15% with comorbid encopresis)

  • Daily intake patterns

  • Voiding and elimination patterns (voiding diary)

  • Psycho...

TREATMENT

GENERAL MEASURES

  • Use nonpharmacologic approaches as first line before prescribing medications 1[A].

  • Simple behavioral interventions (e.g., scheduled wakening, positive reinforcement, bladder t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

DIET
  • Limit fluid and caffeine intake 2 hours before sleep.

  • Limit dairy products 4 hours before sleep (decrease osmotic diuresis).

PATIENT EDUCATION
...

REFERENCES

Robson  WL. Clinical practice. Evaluation and management of enuresis. N Engl J Med.  2009;360(14):1429–1436. [View Abstract on OvidInsights]
Caldwell  PH, Nankivell  G, Sureshkumar  P...

ADDITIONAL READING

Vande Walle J, Rittig S, Bauer S, et al. Practical consensus guidelines for the management of enuresis. Eur J Pediatr.  2012;171(6):971–983.  

SEE ALSO

  • Incontinence, Urinary Adult Female; Incontinence, Urinary Adult Male

  • Algorithm: Enuresis

CODES

ICD10

  • N39.44 Nocturnal enuresis

  • R32 Unspecified urinary incontinence

  • F98.0 Enuresis not due to a substance or known physiol condition

ICD9

  • 788.36 Nocturnal enuresis

  • 788.30 Urinary incontinence, unspec...

CLINICAL PEARLS

  • Initial evaluation is history, exam, and urinalysis.

  • For PMNE in children, if the condition is not distressing to child and caretakers, treatment is unnecessary.

  • Behavioral and lifestyle...

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