![]() Social history family capacity and motivation to engage in treatment, social difficulties (vulnerable child/family).Family history of bedwetting or renal problems.Medical History: consider other co-morbid factors which may exacerbate or prolong nocturnal enuresis developmental or behavioural problems, diabetes mellitus or sleep apnoea.Sleeping arrangements and routine (including own bed/bedroom, snoring and disturbed sleep). ![]() Fluid intake (restrictions in fluid intake, caffeine containing drinks, polydipsia).Bedwetting pattern and trend (nights per week/month, amount, time of night, arousal from sleep).If daytime symptoms predominate, consider treating before bedwetting UTI, poor urinary stream/straining, leakage). Presence of day-time symptoms (frequency, urgency, polyuria, dysuria/recurrent.Secondary enuresis despite adequate management should prompt specialist referral Has the child previously been dry at night without assistance for 6 months? (If so, consider possible medical, emotional, or physical triggers).The pathogenesis involves several possible mechanisms including nocturnal polyuria, detrusor overactivity and an increased arousal thresholdĪcute - last few days to weeks - consider whether this is a presentation of systemic illness).The bed, but this falls to about 1 in 10 by age 6 At 4 years of age, nearly 1 in 3 children wets If the enuresis is infrequent and/or not distressing to the child or parents, treatment is notīladder control and coordination usually occurs by 4 years of age, however night-timeīladder control typically takes longer and is not expected until a child is 5–7 For most children, enuresis is only seen as a problem when it interferes with their ability to socialise with friends (for example overnight stays or school camps). ![]() However, many will feel embarrassed or ashamed and suffer from decreased self-esteem, particularly as the child gets older
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