Discrete episodes of urinary incontinence during sleep in
children ≥ 5 years of age.
(The occurrence of involuntary voiding at 5 yr or more , the age when volitional
control of micturition is expected.)
DEFINITION:
• Enuresis is
a disorder of involuntary micturition in children who are beyond the age when
normal bladder control should have been acquired.
• Enuresis
refers to the wetting of one’s clothes or one’s bed past the age of 3 years.
INCIDENCE
• It is
common during 4 years to 12 years age group.
• Studies
suggest that 2.5 % in the age group of 0-10 years have enuresis and at age 5,
it is 7 % for males and 3 % for females.
Types
Enuresis has been classified into :
• Persistent(primary)
• Regressive
(secondary)
• Nocturnal
• Diurnal
ETIOLOGY
• Genetic
• Psychological
• Physiological
• Organic
• Excess fluid intake
• Enuresis related to stress/trauma
• Psychological crisis
• UTI
• Urethritis
• Diabetes
• Seizures
• Neurogenic bladder
• obstruction
CLINICAL FEATURES
• Incontinence
• Dysuria
• Haematuria
• Straining
on urination
• Dribbling
• Stress
incontinence( with coughing, lifting or running)
• Poor bowel
control
• Continuous
dampness
INVESTIGATIONS
• Full
medical history
• Genital and
neurological examination
• Urinalysis
for albumin, sugar, microscopy, and culture
• if the
child has UTI, he should be further
evaluated by USG, cysto urethrogram and uro dynamic studies.
TREATMENT
• Pharmacologic
– TCA
(imipramine )
– Antidiuretics (desmopressin)
– Antispasmodics
– Combination of behavior and pharmacological modalities
• Non-Pharmacologic
– Behaviour
Modification (positive reinforcement ,token etc)
– Parental
Counselling
– Waking schedule treatment
– Bladder
Exercises
– Retention control training
– Alarm
Device
 |
| Alarm Device |
COMMENTS