Involuntary, urinary incontinence after age of expected bladder control; term generally reserved for children ≥5 years of age; may be
Primary: has never been “dry” for 6 months (80%)
S...
Onset
Nocturnal versus diurnal
Dry period (even if only weeks)
Concomitant recent onset of polydipsia (sometimes accompanied by candidal infections, weight loss) suggests new-onset diabe...
If the problem is affecting only the parents and child is not affected, the treatment should be education and support for the parents.
Avoid all negative interventions.
Minimiz...
99% of cases resolve without treatment.
Spontaneous resolution is ~15% per year after age 5 years.
Physical
Vulvovaginitis
Diaper dermatitis
Emotional
Embarrassment
Poor se...
Arda E, Cakiroglu B, Thomas DT. Primary nocturnal enuresis: a review. Nephrourol Mon. 2016;8(4):e35809. [View Abstract on OvidInsights]
Fagundes SN, Lebl AS, Azevedo Soster L, ...
788.30 Urinary incontinence, unspecified
788.36 Nocturnal enuresis
307.6 Enuresis
R32 Unspecified urinary incontinence
N39.44 Nocturnal enuresis
Q: Do the medications cure the enuresis?
A: None of the medications cure the problem. DDAVP works as an anti-diuretic, reducing the amount of water that is released as urine, resulting in decreased...
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<bold>Figure 29.4.</bold> Surgical therapy for urinary incontinence. (<bold>A1–A3</bold>) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (<bold>A1</bold>) Anterior vaginal wall is opened and undermined. (<bold>A2</bold>) Paraurethral tissue lateral to the urethrovesical (UV) junction is sutured. (<bold>A3</bold>) This creates a firm bar of tissue that supports the UV junction. (<bold>B1–B4</bold>) Retropubic suspension procedures, the Marshall-Marchetti-Krantz procedure. (<bold>B1</bold>) The suture is placed in the per...
<bold>Figure 29.4.</bold> Surgical therapy for urinary incontinence. (<bold>A1–A3</bold>) Anterior vaginal wall re...
Figure 29.5. Surgical therapy for urinary incontinence. (A1-A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior vaginal wall is opened and undermined. (A2) Paraurethral tissue lateral to the urethrovesical (UV) junction is sutured. (A3) This creates a firm bar of tissue that supports the UV junction. (B1-B4) Retropubic suspension procedures, the Marshall-Marchetti-Krantz procedure. (B1) The suture is placed in the periurethral tissue and then into the pubic periost...
Figure 29.5. Surgical therapy for urinary incontinence. (A1-A3) Anterior vaginal wall repair, the Kelly-Kennedy procedure. (A1) Anterior ...
Figure 29.4. Pessaries. (A) Inflatable. (B) Doughnut. (C) Smith-Hodge. (D) Cube.