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Enuresis

Joseph L. Hesse, MD and Swati Avashia, MD, FAAP, FACP, ABIHM Reviewed 06/2019
 


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

  • Age of onset, duration, severity

  • LUT tract symptoms

  • Daily intake patterns

  • Voiding and stooling patterns (voiding diary)

  • Psychosocial history

  • Family history of enuresis

  • Investigation and pre...

TREATMENT

GENERAL MEASURES

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

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • When starting with nonpharmacologic treatment, patient should be seen in clinic every 1 to 3 months.

  • If starting enuresis alarm, patient should r...

REFERENCES

1
Baird DC, Seehusen DA, Bode DV. Enuresis in children: a case based approach. Am Fam Physician.  2014;90(8):560–568. [View Abstract on OvidMedline]
2
Kuwertz-Bröking E, von Gontard A. Cl...

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

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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