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 ?
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.
prevalence Female Male 3% 7% All child 90% 5 y/o childs
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.
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
ETIOLOGY Genetic factors. physiologic factors: psychologic factors:Increase age , hyperactive childrenstress and/or traumatic experiencesOrganic causes:DM, UTI, Small bladder or Neurological problems