A 6 years male child comes with complaints of bedwetting. The child is continent during the day and problem is only at night. Growth and development of the child were normal. Urine microscopy is normal and urine specific gravity was 1.020. How will you manage?
Reassure the parents and follow up after 6 months
Refer to psychiatrist
Complete blood counts
Ultrasound-KUB
Ans: A: Reassure the parents and follow up after 6 monthsExplanation:(Ref: Nelson 20Ie p2585; Ghai 8/e p504)Bed-wetting is normal till 5 years of age.In a child with only night-time bed wetting, when urinalysis (to rule out infections) and urine osmolality (to rule out diabetes) are normal, only regular follow up is required.Treatment:To reassure the child and parents that the condition is self-limited and to avoid punitive measures that can affect the child's psychologic development adversely.Fluid intake should be restricted to 2 oz after 6 or 7 pm.Parents should be ceain that the child voids at bedtime.Avoiding extraneous sugar and caffeine after 4 pm also is beneficial.If the child snores and the adenoids are enlarged, referral to an otolarvngologist should be considered, because adenoidectomv can cure the enuresis.