Pediatric Medicine

Answer 4 Provide reassurance. Most children achieve daytime dryness prior to nighttime dryness and have complete bladder control by age 5 years. However, the prevalence of nocturnal enuresis for boys at age 5 years is still approximately 5% and is likely related to a delay in maturational development of the bladder musculature. This child clearly still falls within the normal range. There is no evidence that reward/punishment strategies have any effectiveness in hastening the resolution of this problem. Although desmopressin acetate may have some effectiveness for patients with nocturnal enuresis, it is not indicated in this child. No evidence indicates that this child needs a psychiatric evaluation or any imaging studies. SUGGESTED READINGS 1. Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 16th ed. Philadelphia: WB Saunders Co; 2000. 2. Gunn VL, Nechyba C, editors. The Harriet Lane handbook: a manual for pediatric house officers. 16th ed. Philadelphia: Mosby; 2002. Click here to return to the questions

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