Childhood enuresis. A comprehensive treatment program.
Enuresis is a common, often misunderstood, condition that affects millions of children in the United States. For most children with primary enuresis, preventing secondary psychological sequelae associated with guilt and shame is an important consideration in the decision whether or not to treat. Because the spontaneous resolution rate is 15 per cent per year, the older the child, the more important treatment becomes. It is important to distinguish primary from secondary enuresis, as most psychogenically induced enuresis is of secondary nature. A careful history can usually elicit the etiology, as well as the exacerbatory factors in both types of conditions, providing direction for treatment. Treatments include pharmacologic, behavioral, and psychotherapeutic. In some cases, surgical intervention of either a urologic or otolaryngologic nature is indicated. A multidimensional approach is often best, and we have described our program with its success rate. Treating the enuretic child can be frustrating, but is usually quite gratifying for the child, parents, and the clinician.
Scharf
M B
MB
Department of Psychiatry, University of Cincinnati School of Medicine, Ohio.
Pravda
M F
MF
Jennings
S W
SW
Kauffman
R
R
Ringel
J
J
D001521:Behavior Therapy; D002648:Child; D003131:Combined Modality Therapy; D004775:Enuresis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012890:Sleep; D001743:Urinary Bladder / Q000503:physiopathology