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Enuresis

Hermione Gaw, MD and Nancy Nguyen, D.O. Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Classification

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

    • Secondary NE: 20% ...

DIAGNOSIS

HISTORY

  • Lower urinary tract symptoms

  • Daily intake patterns, Voiding and stooling patterns (voiding diary); constipation issues

  • Psychosocial history (patient, parental, school/bullying, etc.)

  • Fam...

TREATMENT

GENERAL MEASURES

  • Use nonpharmacologic approaches as first line before prescribing medications (2)[A].

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • With nonpharmacologic treatment, reassess every 1 to 3 months.

  • With enuresis alarm, reassess in 1-3 weeks.

  • With DDAVP, reassess in 1 to 2 weeks, t...

REFERENCES

1
Kuwertz-Bröking  E, von Gontard  A. Clinical management of nocturnal enuresis. Pediatr Nephrol.  2018;33(7):1145–1154. [View Abstract on OvidMedline] ...

SEE ALSO

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

  • Algorithm: Enuresis, Secondary

CODES

ICD10

  • N39.44 Nocturnal enuresis

  • R32 Unspecified urinary incontinence

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

SNOMED

  • 8009008 Nocturnal enuresis (disorder)

  • 165232002 urinary inc...

CLINICAL PEARLS

  • Behavioral and lifestyle interventions are the first-line treatment for PMNE; alarms and desmopressin are the most effective treatments.

  • Secondary Enuresis: most often due to psychosoci...

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