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n CME : Your SA Journal of CPD - Management of bedwetting in children : main topic

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Abstract

Fifteen per cent of 5-year-olds, 7% of 10-year-olds and 1% of 15-year-olds wet their beds. <br>The exact nature of a child's bedwetting needs to be carefully elucidated, making a clear distinction between enuresis and incontinence. <br>Enuresis can be defined as the persistent, involuntary voiding of a normal urine volume during sleep, beyond the age of expected continence (i.e. 5 years). <br>The most common cause of bedwetting is benign enuresis. <br>Benign enuresis (monosymptomatic nocturnal enuresis) is caused by a combination of (i) inadequate arousal response to bladder fullness; (ii) inadequate increase in nocturnal ADH production; and (iii) a small functional bladder capacity. <br>Benign enuresis is recognised by (i) the absence of symptoms or signs of any underlying disease; (ii) wetting that occurs exclusively during sleep; and (iii) normal urinalysis. <br>Primary enuresis is almost never caused by psychological problems. <br>The most common causes of secondary enuresis (relapse after 6 months of dryness) are urinary tract infection and psychological disturbance. <br>The most effective treatment for benign enuresis is alarm therapy. <br>The most effective medication for benign enuresis is DDAVP (desmopressin).

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/content/m_cme/22/8/EJC62836
2004-08-01
2016-12-04
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