NOCTURNAL ENURESIS

on 18.9.08 with 0 comments




("Bed wetter")- Usually in children; Congenital patient never has control - no established record of control; Better able to help mature patient that had control and then lost it; Congenital - small bladder - surgical resolution - found based on urodynamic testing (watch bladder filling and then voiding)

Between ages of 6-8 the patient should have control; Incontinence during night;

  • Secondary enuresis - had control and then lost it;
  • Primary enuresis - congenital form; Around 5 million people effected at any one time;

Multiple etiologies - 3 major themes:
  • Psychological disturbances - depression, parent lost job, parents getting divorce, etc.;
  • Physiologic disturbances (allergies, medications, etc.)
  • Somatovisceral reflex; Food allergies: Brenneman did longest longitudinal study of this problem - followed children for 20 years, Found that 2/3 of enuresis was directly related to food allergies, 60% of the 66% were allergic to cow's milk or cow's milk products;

Classic triad for enuresis child - tended to be bed wetting male, sensitivity testing that lead him to believe that milk was the allergen, Chvostek reflex (tap on zygomatic arch and several quick blinks in succession, hyper-irritability)

Category: Nephrology Notes

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