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enuresis treatment in teens

Enuresis treatment in teens. A detailed assessment should include a full psychiatric assessment. Physical causes need to be excluded and urinary microscopy and culture carried out in all cases. Treatment is unlikely to be successful unless the child and family are motivated.

Behavioural interventions as well as pharmacological treatments have proven to be effective. Using a simple star chart to record dry nights can be effective. If enuresis persists the use of an enuresis alarm is recommended. Originally the device consisted of a buzzer and a pad which was placed under the bedsheet at night. Current models are portable and the pad can be attached to the child’s pyjamas. In both devices when the child wets, the buzzer is set off and the child is expected to go to the toilet. Cure rates of 50+ per cent are reported although a third of children relapse. For resistant cases an intensive form of therapy called the dry-bed training is recommended. This works better with older and motivated children. This technique involves hourly waking during the first night and practice of proper toileting habits.

The medication of choice is desmopressin which is effective in 70 per cent of children. Relapse rates are, however, high. Low dosage tricylic anti-depressants, for example, imipramine have been shown to be effective.

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