Enuresis

Enuresis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate enuresis (wetting): Bladder dysfunction (bladder dysfunction). Dysuria – pain during urination. Daytime wetting (enuresis diurna) Holding maneuver Imperative urge to urinate Micturition postponement Pollakiuria – urge to urinate frequently without increased urination. Stakkatomiktion (urination with repeated interruption of the urine stream). Overactive bladder Frequent nocturnal wetting (enuresis nocturna). … Enuresis: Symptoms, Complaints, Signs

Enuresis: Causes

Pathogenesis (development of disease) Enuresis is divided by cause into: Nonorganic (functional) enuresis: Purely nocturnal enuresis (monosymptomatic enuresis nocturna, NEM). nocturnal enuresis with additional daytime symptoms (non-monosymptomatic enuresis nocturna, non-MEN); especially in: Children with overactive bladder (OAB) and small bladder capacity. Habitual micturition postponement Bladder dysfunction with isolated daytime symptoms: Overactive bladder (OAB) and urge … Enuresis: Causes

Enuresis: Therapy

General measures Note: Nocturnal enuresis is not classified as a condition requiring treatment until the age of 6. Therapy motivation and therapy evaluation (therapy is often lengthy; child-friendly reward systems, e.g., award stars for dry nights). In nocturnal enuresis with additional daytime symptoms (monosymptomatic enuresis nocturna, non-MEN), daytime symptoms should be treated before nocturnal enuresis. … Enuresis: Therapy

Enuresis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of enuresis (enuresis). Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Does your child have school problems? Current medical history/systemic history (somatic and psychological complaints). When does your child wet? During the day … Enuresis: Medical History

Enuresis: Complications

The following are the most important diseases or complications that may be contributed to by enuresis (wetting up): Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Constipation (constipation) Fecal incontinence – inability to hold the urge to defecate. Psyche – nervous system (F00-F99; G00-G99) Anxieties Attention-deficit/hyperactivity disorder (ADHD). Depressive disorders Developmental disorders Motor development … Enuresis: Complications

Enuresis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Spine [inspection of lumbosacral region (lumbar spine-cruciate region): presacral lipoma?, occult dysraphic signs (e.g., spina bifida occulta)?] Genitals (Note: respect children’s sense of shame) [stenosing … Enuresis: Examination

Enuresis: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. Urinalysis by test strip: A rapid test for nitrite detects nitrite-forming bacteria in the urine, if necessary. Likewise, leukocyturia (increased number of white blood cells in the urine) may be detectable. Urine sediment Laboratory parameters 2nd order – depending on the results of the history, … Enuresis: Test and Diagnosis

Enuresis: Drug Therapy

Therapeutic target Decrease in enuresis Therapy recommendations Treatment of comorbid disorders must precede or parallel initiation of urinary incontinence treatment. Standard durotherapy (basic therapy of nonorganic enuresis) [first therapeutic measure]-see “Further therapy” for details. Apparent behavioral therapy (AVT) with a wake-up device; alternatively, in case of high nocturnal urine volume: desmopressin (ADH analogue/antidiuretic hormone); in … Enuresis: Drug Therapy

Enuresis: Diagnostic Tests

Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound of abdominal organs): kidneys and urinary tract [residual urine?, bladder wall thickness/etrusor wall thickness, kidneys, rectal width] (waivable in NEM* ). * NEM (Monosymptomatic Enuresis). Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and mandatory medical device diagnostics – for … Enuresis: Diagnostic Tests