1 / 10

Nocturnal Enuresis (in 10 minutes)

Nocturnal Enuresis (in 10 minutes). By Mohammad Adnan. Definition(s).

colm
Download Presentation

Nocturnal Enuresis (in 10 minutes)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Nocturnal Enuresis (in 10 minutes) By Mohammad Adnan

  2. Definition(s) ‘The Diagnostic & Statistical Manual of Mental Disorders (DSM- IV) defines nocturnal enuresis as an involuntary voiding of urine during sleep, with a severity of at least twice a week, in children aged >5 years in the absence of congenital or acquired defects of the central nervous system ’* Primary – Never been dry at night Secondary – 6m> of bladder control *There is no minimum age limit to allow consideration of the benefit of interventions in younger children (under 7 years) previously excluded from treatment.NICE

  3. Epidemiology • 30% aged 4yrs • 14% aged 5yrs • 10% aged 6yrs • 3% aged 12yrs • 1% aged 18 • Male>Female • 1-2% underlying physical abnormality • Can run in families

  4. Pathophysiology There are a number of different disturbances of physiology that may be associated with the development of bedwetting. These disturbances may be categorised as: • 1. Sleep arousal difficulties – a reduced ability to wake to noise or to bladder contractions. • 2. Polyuria – the production of larger than normal volumes of urine overnight that typically exceed the nocturnal bladder capacity. • 3. Bladder dysfunction – most often either a small bladder capacity or overactive bladder.

  5. History (1) • When did it start? • Ever been dry at night? • How often? • Wet in the Day? • Bowels opening ok, constipation/soiling? • Fluid intake, fizzy drinks/caffeinated • SHx – school/bullying/stress • PMH/DHx/Developmental Hx

  6. Red Flags • Polyuria • Polydipsia • Weight Loss • Abdominal mass

  7. History (2)

  8. History (3) Secondary NE

  9. Examination Should be unremarkable but... • Urine Dipstick • Abdo Exam • Neuro– reflexes?? Do not perform urinalysis routinely, unless the child or young person has: ● started bedwetting recently (in the last few days or weeks) ● daytime symptoms ● any signs of ill health ● a history, symptoms or signs suggestive of urinary tract infection ● a history, symptoms or signs suggestive of diabetes mellitus.

  10. Management • Enuresis clinic • Refer to nice Enuresis Guidelines • Three main option • Conservative • Alarm • Desmopressin

More Related