Historical feature | Possible significance |
Daytime symptoms | Dysfunctional voiding |
Lower urinary tract symptoms (voiding ≥8 or ≤3 times per day, hesitancy, straining, weak stream, intermittent stream, incomplete emptying, postmicturition dribble, genital or lower urinary tract pain) | Dysfunctional voiding or anatomic abnormality (eg, posterior urethral valves) |
Prolonged period of dryness (>6 months) | Secondary enuresis more often associated with psychologic comorbidities |
Frequency of episodes | Nightly enuresis is associated with persistence |
Change in frequency of episodes over time | The natural history is of spontaneous resolution |
Approximate volume of enuretic void | Estimate of bladder capacity |
Fluid intake diary | May suggest etiology of nocturnal polyuria (increased afternoon/evening fluid intake; diabetes mellitus; diabetes insipidus; psychogenic polydipsia) |
Stooling history | Constipation may contribute to decreased bladder capacity |
Review of systems | May identify previously undiagnosed medical condition that contributes to enuresis |
- Snoring | - Obstructive sleep apnea |
- Weight loss, fatigue | - Diabetes, kidney disease |
- Gait abnormalities | - Spinal dysraphism |
- Staring spells | - Seizure disorder |
- Perianal itching, vulvovaginitis | - Pinworms |
- Excessive thirst, nighttime drinking | - Diabetes, kidney disease, psychogenic polydipsia |
Family history of enuresis | Genetic factors may be contributing |