[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

Enuresis

At 11:58 AM 10/8/99 -0400,  wrote:

>
>My point is that there is no easy answer to eneuresis nor "one size fits all".
>It is individual for each child and family.  It's also not about washing
sheets
>for the most part.

I don't think I've seen a PedTalk discussion on enuresis in general.  How
about if the providers chime in with what they do for early school age kids
with enuresis?  My training has been that it's physiological until age six,
at which time about 16% of kids will still be wetting.  Each subsequent
year an additional 16% will spontaneously begin staying dry until by age
11-13 only a very small percentage will still be wetting.  Family history
obviously plays a large part.

So what do you do at the six year visit when the family says the child is
still wetting regularly?  Does this change if there is or is not a strong
FH?  How about if the child says it doesn't bother him/her and the parents
say they don't feel a need for intervention if it doesn't bother the child?
 And how often have you seen an actual physical etiology which has been
discovered by U/A, C&S, or imaging (I don't do imaging routinely but the
urologists seem to like to).

I've not seen a great response to the "basic" advice:  limiting
after-dinner fluids, bladder stretching, midnight wake-ups to use the
bathroom, etc.  I like to offer bed alarms as a first-line intervention,
and I've seen mixed success.

Looking forward to any responses.

Michael Sachs, M.D.
General Pediatrician