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Kimberly Dunn, PNP, Laura Weissman, MD, and Sherry Tsai, CPNP |
Enuresis affects 10 to 20 percent of first-grade boys and 8 to 17 percent of first-grade girls. Diurnal enuresis (daytime incontinence) usually is not diagnosed until age 5 or 6. Nocturnal enuresis (bedwetting) usually is not diagnosed until age 7.
Laura Weissman, MD, a specialist in Developmental and Behavioral Pediatrics at Children's Hospital Boston, says that in most cases, the key to enuresis assessment is a comprehensive history and thorough physical exam. "In most cases, if a child presents with monosymptomatic nocturnal enuresis and otherwise unremarkable history and physical exams, the cause of the enuresis is generally not pathological and can be treated with behavioral therapy."
It's helpful to classify the symptoms of enuresis to guide evaluation. Questions to aid in the process should include the onset of symptoms, timing of symptoms and whether the symptoms are continuous or intermittent.
Assessing a voiding schedule can also be helpful. Questions can include: When does the child urinate and how often? Does the child seem to wet large or small volumes? Does the wetting occur before or after urination? // cont
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