Nocturnal enuresis

 'enuresis' is synonymous with bedwetting  Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age  Children can wet themselves by day or night  It is quite common: about 6% of 5-year-olds and 3% of 10-year-olds are not dry at night. Boys outnumber girls by nearly 2 to 1  There is a genetically determined delay in acquiring sphincter competence, with two-thirds of children with enuresis having an affected first-degree relative.

Organic causes of enuresis are uncommon but include  urinary tract infection  faecal retention severe enough to reduce bladder volume and cause bladder neck dysfunction  polyuria from osmotic diuresis, e.g. diabetes mellitus, or renal concentrating disorders, e.g. chronic renal failure

A urine sample should always be tested for glucose and protein, specific gravity and checked for infection bladder ultrasonography

management of nocturnal enuresis  1. Explanation :The first step is to explain to both child and parent that the problem is common and beyond conscious control  2. Star chart :child earns praise and a star each morning if his bed is dry. the child should not be blamed for wet bed  3. Enuresis alarm :effective in most cases  4. Desmopressin : Short-term relief from bedwetting  5- imipramine