Incontinence, Urine, Pediatric / Enuresis - 47-3
Enuresis is the involuntary passage of urine in a child. The majority of children with enuresis have primary nocturnal enuresis. Daytime and secondary enuresis are much less common, but require differentiating between underlying diseases and stress-related conditions.
- Primary enuresis (e.g., family history)
- Secondary enuresis (e.g., urinary tract infection, vesicoureteral reflux)
In a child five years of age or older, determine whether a physical abnormality is causing the involuntary passage of urine.
Given a patient with enuresis, the candidate will
- list and interpret critical clinical findings, including
- an appropriate history and physical examination to
- determine whether medical reasons underlie the enuresis;
- determine whether a stressful event preceded the occurrence of enuresis (e.g., birth of a sibling);
- list and interpret critical clinical and laboratory findings, including
- urinalysis and urine culture;
- construct an effective management plan, including
- counselling, education, and reassurance of the parents of a child with primary nocturnal enuresis, including treatment options;
- counselling and reassurance of the child to improve self-esteem;
- in the case of secondary enuresis, treatment of the underlying cause;
- determining if the patient needs to be referred to a specialist.