Enuresis
Enuresis is defined as the repeated involuntary voiding of urine into clothes or bed, occurring in children aged 5 years or older, at least twice a week for at least 3 consecutive months.
1. Classification
| Type | Definition |
|---|---|
| Primary | The child has never achieved consistent dryness. |
| Secondary | Dryness achieved for at least 6 months, followed by a relapse. |
2. Clinical Approach
- Exclude Organic Causes: Always rule out UTI, diabetes mellitus/insipidus, and obstructive uropathy.
- Assessment: Check for psychosocial stressors, especially in secondary enuresis.
- Management: Lifestyle modifications (fluid restriction before bed, bladder training) are first-line.
3. Pharmacotherapy
- Desmopressin (DDAVP): Synthetic ADH analogue; used for night-time enuresis.
- Imipramine: A tricyclic antidepressant; effective but used as a second-line agent due to side-effect profile.
NEET PG Hint: The enuresis alarm is considered the most effective long-term treatment for primary nocturnal enuresis. Always remember that secondary enuresis requires a more thorough investigation for underlying psychological or medical triggers compared to primary enuresis.