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Enuresis Differential Diagnoses

  • Author: Wm Lane M Robson, MA, MD, FRCP, FRCP(Glasg); Chief Editor: Marc Cendron, MD  more...
 
Updated: Aug 05, 2015
 
 

Diagnostic Considerations

If a medical condition capable of causing the symptoms (eg, neurogenic bladder, diabetes, or urinary tract infection) is present, the diagnosis of enuresis generally is not made. However, if urinary incontinence was present on a regular basis before these other medical conditions developed or persisted after they were adequately treated, the diagnosis of enuresis is compatible with their presence. In addition, side effects of medications such as antipsychotics and diuretics should be considered as possible causes.

 
 
Contributor Information and Disclosures
Author

Wm Lane M Robson, MA, MD, FRCP, FRCP(Glasg) Medical Director, The Children's Clinic

Wm Lane M Robson, MA, MD, FRCP, FRCP(Glasg) is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada, Royal College of Physicians and Surgeons of Glasgow, Royal Society for Public Health

Disclosure: Nothing to disclose.

Chief Editor

Marc Cendron, MD Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston

Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, New Hampshire Medical Society, Society for Pediatric Urology, Society for Fetal Urology, Johns Hopkins Medical and Surgical Association, European Society for Paediatric Urology

Disclosure: Nothing to disclose.

Acknowledgements

Harry P Koo, MD Chairman of Urology Division and Director of Pediatric Urology, Professor of Surgery, Virginia Commonwealth University School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond

Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association

Disclosure: Nothing to disclose.

Howard M Snyder III, MD Professor, Department of Surgery, Division of Pediatric Urology, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia

Howard M Snyder III, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, and National Kidney Foundation

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
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  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Arlington, VA: American Psychiatric Association; 2013. 355-7.

  5. von Gontard A, Eiberg H, Hollmann E, Rittig S, Lehmkuhl G. Molecular genetics of nocturnal enuresis: linkage to a locus on chromosome 22. Scand J Urol Nephrol Suppl. 1999. 202:76-80. [Medline].

  6. Arnell H, Hjalmas K, Jagervall M, et al. The genetics of primary nocturnal enuresis: inheritance and suggestion of a second major gene on chromosome 12q. J Med Genet. 1997 May. 34(5):360-5. [Medline]. [Full Text].

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  13. Baek M, Park K, Lee HE, Kang JH, Suh HJ, Kim JH, et al. A nationwide epidemiological study of nocturnal enuresis in korean adolescents and adults: population based cross sectional study. J Korean Med Sci. 2013 Jul. 28(7):1065-70. [Medline]. [Full Text].

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  17. Glazener CM, Evans JH. Desmopressin for nocturnal enuresis in children. Cochrane Database Syst Rev. 2002. CD002112. [Medline].

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Table 1. Percent of Children Dry by Day and Night at Various Preschool Ages
Age, y Dry by Day, % Dry by Night, %
22510
2.58548
39878
Table 2. Possible Causes of Primary and Secondary Enuresis
Causes of Primary Enuresis Causes of Secondary Enuresis
Idiopathic



Disorder of sleep arousal



Nocturnal polyuria



Small nocturnal bladder capacity



Idiopathic



Disorder of sleep arousal



Nocturnal polyuria



Small nocturnal bladder capacity



Overactive bladder or dysfunctional voidingOveractive bladder or dysfunctional voiding
CystitisCystitis
ConstipationConstipation
Neurogenic bladderPsychological
Urethral obstructionAcquired neurogenic bladder
PsychologicalSeizure disorder
Ectopic ureterObstructive sleep apnea
Diabetes insipidusDiabetes mellitus
 Acquired diabetes insipidus
 Acquired urethral obstruction
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