Presenting Complaints

• Repeated urination into clothes or bed.

Diagnostic Features

• Delay in ability to control urination (Note: wetting at night is normal until the mental age of 5 years).
• The urination
  • is usually involuntary, though occasionally intentional
  • may be continuous from birth, or may follow a period of continence
  • sometimes occurs with more general emotional or behavioural disorder
  • may begin after stressful or traumatic events
    

Differential Diagnosis

• Most enuresis has no physical cause (primary enuresis), but enuresis may be secondary to:
  • neurological disorder (spina bifida) where urination is also a bit abnormal during the day
  • diabetes or diuretic drugs that may cause polyuria and urgency
  • seizure disorder
  • structural urinary tract abnormality
  • acute urinary tract infection
  • generalized emotional disturbance
• Initial evaluation should include urine examination. If daytime urination is normal and enuresis is the only problem, further testing is usually not necessary