Case history
Case history
A 7-year-old boy is brought to the clinic by his parents, who complain that he continues to wet the bed at night, 2 to 3 times a week. Further investigation determines that both the mother and the father had nocturnal enuresis but report that they just grew out of it. The child and family are clearly distressed about this and are willing to do whatever it takes to improve the situation.
Other presentations
The most common form of enuresis is monosymptomatic nocturnal enuresis, which is usually referred to as bedwetting. Other types of enuresis are associated with baseline voiding dysfunction. All other conditions in which voiding dysfunction manifests itself with the loss of urine are more appropriately defined as incontinence. Monosymptomatic enuresis occurring only at night is dealt with separately from incontinence, both diagnostically and therapeutically.
Parents of young children who have enuresis rarely bring them to a physician, as such behaviour is socially appropriate. The age at which this becomes unacceptable varies from culture to culture. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) and the medical community generally recognise 5 years old as the cut-off.[1] Additionally, the consensus of the International Children's Continence Society is that the number of acceptable wet nights is between 1 and 3 per month; more than this and the child and/or parents are typically concerned enough to bring it to the attention of their physician.[2] Most of these children will present having never been consistently dry. Secondary enuresis can be associated with a stressful life event or a new medical condition, and warrants further investigation.
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