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Chapter 44

front 1

Enuresis

back 1

Children with difficulties in urinary control are defined as having enuresis.

front 2

manifestations

back 2

decreased bladder capacity, underlying urinary tract abnormalities, neurologic alterations, obstructive sleep apnea, constipation, UTI, pinworm infestation, diabetes mellitus, and voiding dysfunction.

front 3

nocturnal eneresis

back 3

is not a matter of excessive concern unless the child is older than 6 years or has markedly decreased self-esteem.

front 4

Diurnal Enuresis

back 4

Children with urgency, frequency, and inappropriate wetting during the day may be seen rushing to the bathroom or tightly crossing their legs.

front 5

The diagnosis of enuresis

back 5

  • Urinalysis and urine culture can rule out possible UTI.
  • Measurements of urine-specific gravity and urine glucose are assessed for underlying diabetes.

front 6

therapeutic management of nocturnal eneuresis

back 6

  • begins with general interventions, such as explaining theories underlying the problem in terms the child can understand.
  • The child is reassured that, with assistance, the problem can resolve. Common sense approaches of limiting fluids after supper and voiding just before bedtime are encouraged.
  • Diet modifications include avoiding extraneous sugar and caffeine intake after 5 PM because these substances can act as bladder stimulants as well as diuretics (Elder, 2020a). Also, the child can be trained to use imagery; thinking about what a full bladder feels like and picturing waking up and going to the bathroom.