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Nocturnal Enuresis
1Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214, USA; Wesley Family Medicine Residency Program, Wichita, KS 67214, USA.
Insights
Nocturnal enuresis, or bedwetting, is common in children and usually resolves naturally. Reassure parents that it is nonvolitional, and focus on behavioral interventions, with medication as a secondary option.
Area of Science:
- Pediatrics
- Urology
- Child Psychology
Background:
- Nocturnal enuresis is a frequent pediatric concern in primary care.
- Most cases are primary, meaning not caused by another medical condition.
- Understanding the nonvolitional nature is key for parental reassurance.
Purpose of the Study:
- To provide guidance on managing nocturnal enuresis in children.
- To emphasize the importance of a thorough history to exclude secondary causes.
- To highlight effective management strategies for primary nocturnal enuresis.
Main Methods:
- Detailed patient history to differentiate primary from secondary enuresis.
- Parental education to demystify the condition and promote reassurance.
- Implementation of behavioral interventions tailored to the child's engagement.
Main Results:
- Most children naturally outgrow nocturnal enuresis.
- Behavioral interventions are the first-line treatment and are most effective with child involvement.
- Medications can be effective when used alongside behavioral strategies.
Conclusions:
- Nocturnal enuresis management requires a multi-faceted approach.
- Parental education and behavioral interventions are crucial for successful outcomes.
- Medication serves as an adjunct to behavioral therapy in treating childhood bedwetting.
Abstract:
Nocturnal enuresis is a common problem that children may present with in a primary care setting. It is important to take a detailed history to rule out secondary causes; however, most cases are primary in nature. It is essential to demystify the problem and reassure parents by educating them that the episodes are nonvolitional and most children outgrow the problem over time. Behavioral interventions are considered first line and are most successful when the child is invested in succeeding. Interventions should be initiated with specific goals in mind. Medications are effective and should be used in conjunction with behavioral interventions.
