NOCTURNAL ENURESIS      Fahad Al Hulaibi
Definition defined as:the voluntary or involuntary repeated discharge of  urine into clothes or bed after a developmental...
   The diagnosis of enuresis is made when urine is    voided:- Twice a week for at least 3 consecutive months-When clinic...
prevalence             Female      Male               3%        7%             All child              90%                 ...
Types   Persistent (primary) type:                  90%    in which the child has never been dry at night   Regressive (...
Further classifications:  Nocturnal enuresis:                         Common in girl                                     ...
ETIOLOGY  Genetic factors. physiologic factors: psychologic factors:Increase age , hyperactive childrenstress and/or tr...
Investigations   Ultrasonography   Uroflowmetry   Urinalysis   urine culture
TREATMENT should begin with behavioral treatment.1. Rewarding the child for being dry at night is a  useful step.
2. The child should void before retiring.3. using an alarm clock to wake the child once 2–3 hr after he or she falls aslee...
 Use of conditioning devices(an alarm that rings when the child wets a special sheet)
  Pharmacotherapy:If behavioral treatment is not working       Imipramine                        (DDAVP)
References             Kliegman R, Stanton B, Behrman             R, Jenson H. Nelson Textbook             of Pediatrics. ...
Nocturnal enuresis
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Nocturnal enuresis

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as apart of Pediatric course 2013 , this was my presentation.
it was presented at 13-3-2013 in front of Dr. Gihan.

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Nocturnal enuresis

  1. 1. NOCTURNAL ENURESIS Fahad Al Hulaibi
  2. 2. Definition defined as:the voluntary or involuntary repeated discharge of urine into clothes or bed after a developmental age when bladder control should be established. When ?
  3. 3.  The diagnosis of enuresis is made when urine is voided:- Twice a week for at least 3 consecutive months-When clinically significant distress occurs in areas of the childs life as a result of the wetting.
  4. 4. prevalence Female Male 3% 7% All child 90% 5 y/o childs
  5. 5. Types Persistent (primary) type: 90% in which the child has never been dry at night Regressive (secondary) type: in which a child who has been continent for 6 mo or longer then begins to wet the bed.
  6. 6. Further classifications: Nocturnal enuresis: Common in girl Rarely happened after 9y/ovoiding urine at nightMost common causes is: micturition deferralOther causes: is urinary tract infection, chemical urethritis, associated constipation, diabetes, and giggle or stress incontinence Diurnal enuresis :voiding urine while awake
  7. 7. ETIOLOGY Genetic factors. physiologic factors: psychologic factors:Increase age , hyperactive childrenstress and/or traumatic experiencesOrganic causes:DM, UTI, Small bladder or Neurological problems
  8. 8. Investigations Ultrasonography Uroflowmetry Urinalysis urine culture
  9. 9. TREATMENT should begin with behavioral treatment.1. Rewarding the child for being dry at night is a useful step.
  10. 10. 2. The child should void before retiring.3. using an alarm clock to wake the child once 2–3 hr after he or she falls asleep is indicated.4. No Punishment of the child.
  11. 11.  Use of conditioning devices(an alarm that rings when the child wets a special sheet)
  12. 12.  Pharmacotherapy:If behavioral treatment is not working Imipramine (DDAVP)
  13. 13. References Kliegman R, Stanton B, Behrman R, Jenson H. Nelson Textbook of Pediatrics. 18th ed. 2007. Saunders Elseveir.

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