Diurnal enuresis

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Diurnal enuresis
Specialty Pediatrics

Diurnal enuresis is daytime wetting (functional daytime urinary incontinence). Nocturnal enuresis is nighttime wetting. Enuresis is defined as the involuntary voiding of urine beyond the age of anticipated control. Both of these conditions can occur at the same time, although many children with nighttime wetting will not have wetting during the day. Children with daytime wetting may have frequent urination, have urgent urination or dribble after urinating.

Contents

The DSM-V classifies enuresis as an elimination disorder and as such it may be defined as the involuntary or voluntary elimination of urine into inappropriate places. A patient must be of at least a developmental level equivalent to the chronological age of a 5 year old in order to be diagnosed with enuresis (in other words it is not abnormal for a child below the age of 5).

The patient must either experience a frequency of inappropriate voiding at least twice a week for a period of at least 3 consecutive months OR experience clinically significant distress or impairment in social, occupational or other important areas of functioning, in order to be diagnosed with enuresis. These symptoms must not be due to any underlying medical condition (e.g. a child who wets the bed because their kidneys produce too much urine, does not have enuresis, they have kidney disease which is causing the inappropriate urination). Also, these symptoms must not be due exclusively to the direct physiological effect of a substance (such as a diuretic or antipsychotic).

Causes

Common causes include, but not limited to:[ citation needed ]

Management

Management approaches include reassuring families that the child is not wetting their pants on purpose and treatment should include positive reinforcement (not punishment). [1] Non-invasive treatments include keeping a diary to track when the child does not make it to the bathroom on time, ruling out and treating urinary tract infections, ensuring the child is not constipated, hydration, timed voiding, correction of constipation, and in some cases, computer assisted pelvic floor retraining. [1] [2] The effectiveness of non-surgical and non-pharmaceutical interventions for treating children with daytime urinary incontinence is not clear. [2] Bladder stretching exercises (where the person tries to hold their urine as long as possible) are no longer recommended. [2] Bladder stretching exercises can be dangerous because the person could develop the long-term habit of tightening the urethral sphincter muscle, which can cause bladder or kidney problems.[ citation needed ] Urinating on a regular basis is suggested. [1]

Epidemiology

Daytime wetting is more common in girls, while bedwetting is three times as prevalent in boys (i.e., around 75% of those affected are male). At the age of 7 approximately 3% of girls and 2% of boys experience functional daytime wetting at least once a week. [3]

See also

Related Research Articles

<span class="mw-page-title-main">Urinary system</span> Human anatomical system consisting of the kidneys, ureters, urinary bladder, and the urethra

The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's drainage system for the eventual removal of urine. The kidneys have an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each kidney consists of functional units called nephrons. Following filtration of blood and further processing, wastes exit the kidney via the ureters, tubes made of smooth muscle fibres that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination. The female and male urinary system are very similar, differing only in the length of the urethra.

<span class="mw-page-title-main">Urination</span> Release of urine from the urinary bladder

Urination is the release of urine from the bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, pissing, and euphemistically going number one. In healthy humans and other animals, the process of urination is under voluntary control. In infants, some elderly individuals, and those with neurological injury, urination may occur as a reflex. It is normal for adult humans to urinate up to seven times during the day.

<span class="mw-page-title-main">Urinary incontinence</span> Uncontrolled leakage of urine

Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis. UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others.

<span class="mw-page-title-main">Nocturnal enuresis</span> Involuntary urination while asleep

Nocturnal enuresis (NE), also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections.

<span class="mw-page-title-main">Enuresis</span> Involuntary urination in an older child or adult

Enuresis is a repeated inability to control urination. Use of the term is usually limited to describing people old enough to be expected to exercise such control. Involuntary urination is also known as urinary incontinence. The term "enuresis" comes from the Ancient Greek: ἐνούρησις, romanized: enoúrēsis.

Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments.

<span class="mw-page-title-main">Toilet training</span> Training an infant to use the toilet

Toilet training is the process of training someone, particularly a toddler or infant, to use the toilet for urination and defecation. Attitudes toward training in recent history have fluctuated substantially, and may vary across cultures and according to demographics. Many of the contemporary approaches to toilet training favor a behaviouralism- and cognitive psychology-based approach.

Nocturia is defined by the International Continence Society (ICS) as “the complaint that the individual has to wake at night one or more times for voiding .” The term is derived from Latin nox, night, and Greek [τα] ούρα, urine. Causes are varied and can be difficult to discern. Although not every patient needs treatment, most people seek treatment for severe nocturia, waking up to void more than 2–3 times per night.

Frequent urination, or urinary frequency, is the need to urinate more often than usual. Diuretics are medications that increase urinary frequency. Nocturia is the need of frequent urination at night. The most common cause of this condition for women and children is a urinary tract infection. The most common cause of urinary frequency in older men is an enlarged prostate.

A bedwetting alarm is a behavioral treatment for nocturnal enuresis.

<span class="mw-page-title-main">Propantheline bromide</span> Drug for functional gastrointestinal disorders

Propantheline bromide (INN) is an antimuscarinic agent used for the treatment of excessive sweating (hyperhidrosis), cramps or spasms of the stomach, intestines (gut) or bladder, and involuntary urination (enuresis). It can also be used to control the symptoms of irritable bowel syndrome and similar conditions. This agent can also be used for patients who experience intense GI symptoms while tapering off of TCAs.

<span class="mw-page-title-main">Solifenacin</span> Chemical compound

Solifenacin, sold as the brand name Vesicare among others, is a medicine used to treat overactive bladder and neurogenic detrusor overactivity (NDO). It may help with incontinence, urinary frequency, and urinary urgency.

A urine collection device or UCD is a device that allows the collection of urine for analysis or for purposes of simple elimination. UCDs of the latter type are sometimes called piddle packs.

Neurogenic bladder dysfunction, often called by the shortened term neurogenic bladder, refers to urinary bladder problems due to disease or injury of the central nervous system or peripheral nerves involved in the control of urination. There are multiple types of neurogenic bladder depending on the underlying cause and the symptoms. Symptoms include overactive bladder, urinary urgency, frequency, incontinence or difficulty passing urine. A range of diseases or conditions can cause neurogenic bladder including spinal cord injury, multiple sclerosis, stroke, brain injury, spina bifida, peripheral nerve damage, Parkinson's disease, or other neurodegenerative diseases. Neurogenic bladder can be diagnosed through a history and physical as well as imaging and more specialized testing. In addition to symptomatic treatment, treatment depends on the nature of the underlying disease and can be managed with behavioral changes, medications, surgeries, or other procedures. The symptoms of neurogenic bladder, especially incontinence, can severely degrade a person's quality of life.

<span class="mw-page-title-main">Overactive bladder</span> Condition where a person has a frequent need to urinate

Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. The frequent need to urinate may occur during the day, at night, or both. Loss of bladder control may occur with this condition. Overactive bladder affects approximately 11% of the population and more than 40% of people with overactive bladder have incontinence. Conversely, about 40% to 70% of urinary incontinence is due to overactive bladder. Overactive bladder is not life-threatening, but most people with the condition have problems for years.

Omorashi, sometimes abbreviated as simply "omo", is a form of fetish subculture first categorized and predominately recognized in Japan, in which arousal from the idea or feeling of having a full bladder and potentially wetting themselves, or from witnessing another person in that situation.

Urologic diseases or conditions include urinary tract infections, kidney stones, bladder control problems, and prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions. Kidney diseases are normally investigated and treated by nephrologists, while the specialty of urology deals with problems in the other organs. Gynecologists may deal with problems of incontinence in women.

<span class="mw-page-title-main">Overflow incontinence</span> Medical condition

Overflow incontinence is a concept of urinary incontinence, characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition occurs in people who have a blockage of the bladder outlet, or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Overflow incontinence may also be a side effect of certain medications.

Giggle incontinence, giggle enuresis or enuresis risoria is the involuntary release of urine in response to giggling or laughter. The bladder may empty completely or only partially.

Functional incontinence is a form of urinary incontinence in which a person is usually aware of the need to urinate, but for one or more physical or mental reasons they are unable to get to a bathroom. The loss of urine can vary, from small leakages to full emptying of the bladder.

References

  1. 1 2 3 Bernard-Bonnin AC (May 2000). "Diurnal enuresis in childhood". Can Fam Physician. 46: 1109–15. PMC   2144882 . PMID   10845137.
  2. 1 2 3 Buckley, Brian S.; Sanders, Caroline D.; Spineli, Loukia; Deng, Qiaoling; Kwong, Joey Sw (2019-09-18). "Conservative interventions for treating functional daytime urinary incontinence in children". The Cochrane Database of Systematic Reviews. 9: CD012367. doi:10.1002/14651858.CD012367.pub2. ISSN   1469-493X. PMC   6749940 . PMID   31532563.
  3. ↑ "http://www.eric.org.uk/DaytimeWetting/info_daytime_wetting_professionals Archived 2011-11-22 at the Wayback Machine "
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