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Nocturnal Enuresis
Hello friends, in this video we will speak about nocturnal Enuresis .
Nocturnal means night, Enuresis means passing urine
So nocturnal Enuresis is nothing but involuntary urination at night beyond 5 years of age irrespective of a boy or girls
. Ususally the children become dry at night by 3 years of age ,
Now coming to the epidemiology :
It is seen in males more than females
It has a positive family history in 50 percent cases .
Coming to the classification , it can be divided into primary and secondary .
So primary is when a child has never attained night time bed continence , since early childhood days the child has continued to bedwet
Whereas , in secondary the child has attained nighttime continence previously .
It can happen due to any aquired causes , like diabetes , urinary tract infection etc .
Now nocturnal aneuresis can be divided into mono symptomatic and poly symptomatic .
Mono symptomatic is only when the child has nocturnal enuresis and no other symptoms .
Poly symptomatic is when it involves other genitourinary symptoms along with nocturnal enuresis .
Now do we manage it?
1st line management:
Lifestyle changes :
You ask the parents to have early dinner specially for the child .
. Restrict fluid intake during evening.
. Void bladder before bed time .
Motivational therapy .
So everytime the child is dry give a star , and if there’s 7 to 10 stars back to back give the child a reward . So this is a kind of positive reinforcement
Second line treatment .
Bed and alarm technique :
Moisture sensing alarm is fitted , so when it starts ringing the child voids at night .
. The child will get conditioned to wake up at night and go to the washroom to void .
Third line therapy :
Pharmacotherapy , it is ususally given for short period of time .
So the drugs given are oral desmopressin , imipramine, oxybutynin .
So this is all about nocturnal enuresis ,Thank you !
