Paediatrics Q2

Nocturnal Enuresis Table: Introduction and Types

Topic/Area Nocturnal Enuresis
Introduction The majority of children achieve daytime and night-time continence by age 3 or 4. The condition is termed “enuresis” when there is an involuntary discharge of urine by day or night or both, in a child age 5 or older, in the absence of congenital or acquired defects of the nervous system or urinary tract.
Types i. Primary Enuresis: The child has never achieved continence before.
ii. Secondary Enuresis: The child has been dry for at least 6 months but has started bedwetting again.

 

Type of Enuresis Management Recommendations
Primary Enuresis i. With Daytime Symptoms: Refer to secondary care or enuresis clinic for further assessment.
i. Without Daytime Symptoms and < 5 YO: Reassurance that the child may soon achieve continence.
Without Daytime Symptoms and > 5 YO:

Infrequent (<2 times a week): Reassure

Frequent (>2 times a week):

1: Long-term control required: Enuresis alarm (first-line) and reward system.

2: Short-term control required: Desmopressin for temporary control (e.g., sleepover).

3: After 2 complete courses of treatment with no success: Refer to secondary care.
Secondary Enuresis i. Refer to the paediatrics department for further evaluation and management.

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