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Enuresis 1
Published in Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy, Primary Child and Adolescent Mental Health, 2019
Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy
Daytime wetting (diurnal enuresis) is more common in girls than boys. If children develop daytime wetting having been dry, it is important to rule out urinary infection and constipation and also to consider the fact that bladder sensation can be reduced by anxiety. If the child is deliberately wetting in various places in the house, this suggests emotional disturbance, which may need further psychological assessment.
Enuresis
Published in Quentin Spender, Niki Salt, Judith Dawkins, Tony Kendrick, Peter Hill, David Hall, Jackie Carnell, Child Mental Health in Primary Care, 2018
Quentin Spender, Niki Salt, Judith Dawkins, Tony Kendrick, Peter Hill, David Hall, Jackie Carnell
Diurnal enuresis is more common in girls. If children develop daytime wetting after having been dry, it is important to rule out urinary infection and to consider the fact that bladder sensation can be reduced if a child is preoccupied (e.g. by worry). If the child is deliberately wetting in various places in the house, this suggests an emotional disturbance.
Daytime Wetting
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
Daytime wetting is common in children. In adults its occurrence indicates the presence of underlying pathology. In children it must be assessed in terms of the child’s age, presence of a history of urinary tract infections (UTIs), vesicoureteric reflux and constipation. The overall prevalence of daytime wetting among school- age children is 17%; however, more specific data are required when discussing the issue with parents. The natural history of daytime wetting in children has been assessed in a large British cohort. The wetting frequency was classified as infrequent incontinence (wetting fewer than two times a week) or as frequent incontinence defined by the Diagnostic and Statistical Manual of Mental Disorders criteria (wetting more than two times a week). The prevalence rates of infrequent and frequent incontinence at 4.5 years were 13.5% and 1.9%, respectively; at 5.5 years they were 7.8% and 1.5%, respectively; at 6.5 years they were 9.7% and 1.0%; at 7.5 years they were 6.9% and 1.0%; and at 9.5 years they were 4.4% and 0.5%.
Pharmacologic therapies for the management of non-neurogenic urinary incontinence in children
Published in Expert Opinion on Pharmacotherapy, 2019
Tiernan Middleton, Pamela Ellsworth
A retrospective review of 27 patients with daytime wetting by Van Arendonk investigated the efficacy switching from Ditropan to Ditropan XL. The reason for the change included lack of improvement (n = 11) and dislike of taste (n = 21). The mean dosage of Ditropan and Ditropan XL didn’t significantly change (0.40 and 0.38mg/kg/day). After the change, six patients reported resolution of side effects although seven developed new side effects. Of the 27 patients, 13 or had a significant improvement or attained dryness by the first visit after the switch. A significant increase in voided volume (38% versus 53%, p, 0.01) and total bladder capacity (55% versus 70%, p = 0.03) normalized for age-expected bladder capacity, occurred by the first clinical visit after beginning extended-release oxybutynin[48].