NOCTURNAL ENURESIS Flashcards

1
Q

What is the definition of enuresis?

A

Enuresis may be defined as the ‘involuntary discharge of urine by day or night or both, in a child aged 5 years or older, in the absence of congenital or acquired defects of the nervous system or urinary tract’.

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2
Q

At what age do most children achieve day and night time continence?

A

By 3 or 4 years of age.

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3
Q

What is the difference between primary and secondary nocturnal enuresis?

A

Primary - the child has never achieved continence

Secondary - the child has been dry for at least 6 months before

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4
Q

According to NICE guidelines, what is first line in the management of nocturnal enuresis?

A

Reward systems - eg Star charts

NICE recommend these ‘should be given for agreed behaviour rather than dry nights’ e.g. Using the toilet to pass urine before sleep

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5
Q

If a 5 year old child is struggling with nocturnal enuresis despite a trial of a star chart, what is the next step in the management according to NICE?

A

Enuresis alarm

This is as long as the child in under 7 years old.

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6
Q

An 8 year old child is struggling with nocturnal enuresis. What is the first line management according to NICE guidelines?

A

Desmopressin may be used first-line for children over the ago 7 years, particularly if short-term control is needed or an enuresis alarm has been ineffective/is not acceptable to the family.

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