How is it assessed?
A careful history and physical examination will exclude most physical causes of enuresis such as spina bifida, kidney disease and neurological problems.
Investigations will include -:
- Urinalysis to exclude infection and diabetes
and may include -:
- Ultrasound of kidneys, ureters and bladder (US KUB) may be carried out to confirm that the urinary tract is normal.
A careful and complete history of enuresis will be taken on the first visit to the enuresis clinic during which the following information is likely to have been recorded -:
- Toileting history to distinguish primary from secondary enuresis.
- Frequency of wet nights, fluid intake (day and night) or symptoms such as frequency, dribbling and the presence of constipation. Wetting 1-2 times a week may be described as mild, wetting 3-6 times a week may be described moderate and wetting every night may be described as severe.
- whether there is a family history of nocturnal enuresis
- Identify predisposing environmental factors such as stress and emotional disturbances (particularly important in secondary nocturnal enuresis)
The physical examination and investigations should be normal. If they are not, a diagnosis of nocturnal enuresis cannot be made.
