{"product_id":"2940154544280","title":"Nocturnal Enuresis, (Night Urination) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions","description":"\u003cp\u003eNocturnal enuresis (NE) is when a child after age 5 or 6 wets the bed at night, more than twice a week.\u003cbr\u003eIt affects boys more than girls and has a prevalence of 15%.\u003cbr\u003eThere are 2 types of Nocturnal enuresis:\u003cbr\u003e1. Primary enuresis.\u003cbr\u003eChildren who have never been consistently dry at night for more than 6 months.\u003cbr\u003eThis most often happens when the body makes more urine at night than what the bladder can retain, and the child does not wake up when the bladder is full.\u003cbr\u003eThe child's brain has not learned to respond to the signal that the bladder is full.\u003cbr\u003eThis is the most frequent reason for nocturnal enuresis.\u003cbr\u003eThis is the recurrent involuntary passage of urine during sleep by a child aged 5 years or older, who has never achieved consistent night-time dryness.\u003cbr\u003eThis may further be subdivided into:\u003cbr\u003ea. Primary nocturnal enuresis without daytime symptoms: children who have enuresis only at night.\u003cbr\u003eb. Primary nocturnal enuresis with daytime symptoms: those who also have daytime symptoms, such as urgency, frequency, or daytime wetting.\u003cbr\u003e2. Secondary enuresis.\u003cbr\u003eSecondary enuresis indicates children who were dry for at least 6 months, but start nocturnal enuresis again.\u003cbr\u003eThere are many reasons that children wet the bed after being fully toilet trained.\u003cbr\u003eIt might be physical, emotional, or just a change in sleep.\u003cbr\u003eThe cause of nocturnal enuresis is believed to be multi-factoral and that include:\u003cbr\u003eGenetic Causes\u003cbr\u003ePsychological Causes\u003cbr\u003e1.Nocturnal polyuria\u003cbr\u003e2.Small functional bladder capacity\u003cbr\u003e3.Detrusor instability\u003cbr\u003e4.Disorder of sleep arousal\u003cbr\u003e5.Delay in maturation\u003cbr\u003e6.Global maturation delay\u003cbr\u003eSocial Causes\u003cbr\u003eSymptoms:\u003cbr\u003eFrequency\u003cbr\u003eUrgency\u003cbr\u003eDaytime wetting.\u003cbr\u003eDifficulty with poor stream.\u003cbr\u003ePain on urination\u003cbr\u003eThe doctor should assess for underlying cause:\u003cbr\u003e1.Constipation.\u003cbr\u003e2.UTI.\u003cbr\u003e3.Diabetes mellitus.\u003cbr\u003e4.Behavioral and emotional difficulties.\u003cbr\u003e5.Child maltreatment\u003cbr\u003eDiagnosis:\u003cbr\u003eThe doctor should investigate (and treat) daytime symptoms before addressing enuresis - e.g., symptoms suggestive of diabetes, UTIs or constipation.\u003cbr\u003eThe doctor should consider asking parents to keep a diary of the child's nocturnal enuresis patterns, daytime symptoms, toileting pattern and fluid intake\u003cbr\u003eA child should have a physical exam and a urine test to rule out urinary tract infection or other causes.\u003cbr\u003eNo further investigations are needed if urinalysis is normal.\u003cbr\u003eNocturnal enuresis can be very distressing, especially for older children.\u003cbr\u003eIt may lead to social isolation, bullying and low self-esteem\u003cbr\u003eConservative therapies\u003cbr\u003e1.Explanation and reassurance\u003cbr\u003e2.Advise children to avoid caffeine-containing drinks before bedtime.\u003cbr\u003e3.Manage constipation\u003cbr\u003eSimple behavioral therapies:\u003cbr\u003eMore children become dry when given rewards\u003cbr\u003eIf the child wakes at night, encourage them to use the toilet before returning to sleep\u003cbr\u003eUrotherapy involves:\u003cbr\u003e1.Timed voiding\u003cbr\u003e2.Advice on good hydration\u003cbr\u003e3.Reduction in diuretic fluids\u003cbr\u003e4.Avoiding fluid intake before sleep\u003cbr\u003e5.Emptying the bladder before sleep\u003cbr\u003eConstipation should be treated\u003cbr\u003eEnuresis alarms:\u003cbr\u003eIt serves as a conditioning device using a noise to link the stimulus of a full bladder\u003cbr\u003eTreatment is continued for 3-4 months and stopped when the child has remained dry for a consecutive three weeks\u003cbr\u003eDesmopressin\u003cbr\u003eDesmopressin should be given first-line to children over 7 years of age when rapid control is required\u003cbr\u003eOtherwise it should be used second-line after an alarm has been tried.\u003cbr\u003eTricyclics antidepressant is effective at reducing the number of wet nights during treatment\u003cbr\u003eImipramine is approved for use in treating nocturnal enuresis in children aged 6 years and above but is reserved for treating resistant cases\u003cbr\u003eCombination therapy with anticholinergic treatment increases the efficacy of treatment.\u003c\/p\u003e\u003cp\u003eTABLE OF CONTENT\u003cbr\u003eIntroduction\u003cbr\u003eChapter 1 Nocturnal Enuresis\u003cbr\u003eChapter 2 Causes\u003cbr\u003eChapter 3 Symptoms\u003cbr\u003eChapter 4 Diagnosis\u003cbr\u003eChapter 5 Treatment\u003cbr\u003eChapter 6 Prognosis\u003cbr\u003eChapter 7 Urinary Incontinence\u003cbr\u003eChapter 8 Cystitis\u003cbr\u003eEpilogue\u003c\/p\u003e","brand":"Kenneth Kee","offers":[{"title":"Default Title","offer_id":47103651643632,"sku":"2940154544280","price":2.99,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0737\/7593\/9824\/files\/2940154544280_p0.jpg?v=1764070229","url":"https:\/\/shop-qa.barnesandnoble.com\/products\/2940154544280","provider":"Barnes \u0026 Noble (DEV)","version":"1.0","type":"link"}