| Establish goals/priorities |
| Staying dry for particular occasions (eg, sleepover, camp) |
| Reduce the number of wet nights |
| Reduce the impact of enuresis on the child and family |
| Avoid recurrence |
| Establish expectations |
Enuresis treatment: - Often requires several methods, used in sequence or combination
- May be prolonged
- May fail in the short term
- Relapse is common
|
Parents/families must: - Be willing to participate
- Be supportive
- Adhere to follow-up
|
| Education and advice |
| Enuresis is common (occurs in approximately 15% of 5 year olds and resolves on its own in most patients). |
| Enuresis is not the fault of the child. The child should not be punished for wetting the bed. |
| Enuresis is also not the fault of the parents/caregivers. |
The impact of bedwetting can be decreased by: - Using bed protection and washable/disposable products
- Using room deodorizers
- Thoroughly washing the child before dressing
- Using emollients to prevent chafing
|
| Keeping a calendar of wet and dry nights helps to determine the effect of interventions. |
| The child should attempt to void 4 to 7 times per day, including just before going to bed. |
| If the child wakes at night, the caregiver should take the child to the toilet. |
| High-sugar and caffeine-based drinks should be avoided, particularly in the evening. |
| Providing a smaller proportion of the child's daily fluid intake (ie, 20%) after 5 PM may be helpful in some children but should be continued only if it is successful. |
| Routine use of diapers and pull-ups can interfere with motivation to get up at night and is generally discouraged (except when the child is sleeping away from home). |
