Rationale
Pediatric enuresis is the involuntary passage of urine in a child. Most children with enuresis have primary nocturnal enuresis. Daytime and secondary enuresis are much less common but require differentiating between underlying pathology and functional conditions.
Causal Conditions
(list not exhaustive)
- Primary enuresis (e.g., family history)
- Secondary enuresis (e.g., urinary tract infection, vesicoureteral reflux)
Key Objective
In a child who is five years of age or older, the candidate will determine whether a medical reason is causing the enuresis.
Enabling Objectives
Given a patient with enuresis, the candidate will
- list and interpret critical clinical findings, including those based on an appropriate history and physical examination to determine whether
- medical reasons underlie the enuresis, or
- a precipitating stressful event preceded the enuresis;
- list and interpret critical clinical and laboratory findings, including a urinalysis and urine culture;
- construct an effective management plan, including
- counselling, education, and reassurance of the parents or guardians of a patient with primary nocturnal enuresis, including treatment options,
- counselling and reassurance of the patient to improve self-esteem,
- treatment of the underlying cause in the case of secondary enuresis, and
- determining if the patient needs to be referred to a specialist.
