Summary
Definition
History and exam
Key diagnostic factors
- increased fluid intake at night
- urinary frequency
- constipation
- caffeine and other bladder irritants
- urinary urgency
Other diagnostic factors
- abnormal voiding habits
- abnormal breathing pattern at night
Risk factors
- genetic predisposition
- constipation
- upper airway obstruction/sleep-disordered breathing
- ADHD
- psychological disorders
- male sex
Diagnostic investigations
1st investigations to order
- urinalysis
Investigations to consider
- urinary tract ultrasound
Treatment algorithm
age <7 years
age ≥7 years
recurrence
Contributors
Authors
Erin C. Grantham, MD
Pediatric Urologist
Department of Urology
Billings Clinic
Billings
MT
Disclosures
ECG declares that she has no competing interests.
Acknowledgements
Dr Erin C. Grantham would like to gratefully acknowledge Dr Duncan T. Wilcox and Dr Nicholas G. Cost, the previous contributors to this topic. Dr Erin C. Grantham would also like to acknowledge Jillian Hatfield for her contribution to this topic.
Declarações
DTW and NGC declare that they have no competing interests.
Revisores
Prasad Godbole, FRCS, FRCS (Paed), FEAPU
Consultant Paediatric Urologist
Paediatric Surgical Unit
Sheffield Children's NHS Foundation Trust
Western Bank
Sheffield
UK
Declarações
PG declares that he has no competing interests.
Elizabeth Jackson, MD
Associate Professor
Pediatric Nephrology
Cincinnati Children's Hospital Medical Center
Cincinnati
OH
Declarações
EJ declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text Revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
European Association of Urology. Guidelines on paediatric urology. 2023 [internet publication].Texto completo
European Association of Urology. Guidelines on paediatric urology. 2019 [internet publication].Texto completo
Nevéus T, Eggert P, Evans J, et al. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society. J Urol. 2010 Feb;183(2):441-7.Texto completo Resumo
Nevéus T, Eggert P, Evans J, et al. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society. J Urol. 2010 Feb;183(2):441-7. Resumo
Caldwell PH, Codarini M, Stewart F, et al. Alarm interventions for nocturnal enuresis in children. Cochrane Database Syst Rev. 2020 May 4;5(5):CD002911.Texto completo Resumo
Longstaffe S, Moffat M, Whalen J. Behavioral and self-esteem changes after six months of enuresis treatment: a randomized, controlled trial. Pediatrics. 2000;105:935-940. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Congenital abnormality of the urinary tract (e.g., ectopic ureter, ureterocele, and urethral valves)
- Constipation
- Diabetes
Mais Diagnósticos diferenciaisDiretrizes
- Guidelines on paediatric urology
- Diagnosis and management of nocturia
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