Enuresis

Question 1

Enuresis treatment

Answer 1

History:

• Urinary history - urgency, frequency, bowels
• Toilet training
• Incontinence episodes day/night
• ?Ever previously dry
• Impact on child/family
• Fluid intake / caffeine
• Environment at home

Investigations: consider organic causes

• Urine MCS ?UTI
• Post void residual
• MCUG
• Urodynamics
• Renal tract USS

Management:

• Bladder diary
• Non-pharmacological: Pad + bell alarm, timed voiding
• Medication: Oxybutynin, desmopressin
• Referral renal/urology