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enuresis in children

Elimination disorders:Enuresis

Many would argue whether enuresis should be seen as a mental health problem. Enuresis may be primary when bladder control has never been achieved or secondary when bladder control is lost after a child has acquired bladder control for at least six months. Boys are more prone to nocturnal enuresis (bed wetting at night) while girls are more prone to diurnal enuresis. Once continence is achieved relapse occurs most commonly around the age of 5 or 6. The male:female sex ratio for nocturnal enuresis rises from 1:1 at the age of 5 to nearly 2:1 in adolescence.

Aetiology

Seventy per cent of enuretic children have a first-degree relative with a history of wetting. Enuretic children are more likely to show other developmental delay; language and motor delays being twice as common as among controls. Delay beyond 20 months in starting toilet training is associated with a higher incidence of enuresis. Girls with enuresis are more likely to suffer from urinary tract infections (5 per cent of 5-year-old enuretics). Enuresis is associated with stressful life events at the age of 3–4 years and these include early separations, birth of siblings, accidents and admissions to hospital. Enuresis is associated with social disadvantage and institutional care.

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