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Diurnal enuresis
1Children's Hospital, Greenville Hospital System, SC, USA.
Insights
Daytime wetting in children is usually a self-limited issue with a clear cause. A thorough history and simple tests like urinalysis and bladder ultrasound are key to diagnosis and treatment.
Area of Science:
- Pediatric Urology
- Childhood Health
Background:
- Daytime wetting, also known as diurnal enuresis, is a frequent childhood concern.
- Most cases are benign, intermittent, and have identifiable causes.
Purpose of the Study:
- To outline the diagnostic approach for daytime wetting in children.
- To emphasize the importance of clinical history in assessment.
- To describe appropriate diagnostic imaging studies.
Main Methods:
- Clinical history taking is the primary assessment tool.
- Urinalysis is used to detect urinary tract infections (UTIs).
- Renal and bladder ultrasonography serve as initial noninvasive screening.
Main Results:
- Most childhood daytime wetting cases have benign, easily identifiable causes.
- Urinalysis and ultrasonography are effective initial diagnostic steps.
- Invasive imaging is reserved for specific obstructive or neurogenic conditions.
Conclusions:
- The prognosis for most children with daytime wetting is excellent with timely treatment.
- A systematic diagnostic approach, starting with history and noninvasive tests, is effective.
- Further investigation is guided by clinical suspicion of underlying pathology.
Abstract:
Daytime wetting is a common problem in childhood; in most cases, it is an intermittent or self-limited problem with a benign and easily identifiable cause. The history is the most important aspect of the assessment. A urinalysis is helpful to look for UTI, and ultrasonography of both the kidney and the bladder is an excellent noninvasive screening study. More invasive diagnostic imaging studies are necessary only if the patient has symptoms or signs suggestive of urethral obstruction, neurogenic bladder, Hinman syndrome, or ectopic ureter. With time and appropriate treatment, the prognosis is excellent for the majority of patients.