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Bedwetting - Coggle Diagram
Bedwetting
Assessment
Enquire whether they have previously been dry at night without assistance for 6 months (secondary bedwetting).
Consider the possibility of child maltreatment if: the child is reported to be deliberately bedwetting and/or parents/carers are seen or reported to punish the child for bedwetting despite professional advice that the symptom is involuntary, The child has secondary daytime wetting or secondary bedwetting that persists despite adequate assessment and management unless there is a medical explanation or clearly identified stressful situation.
Ask about daytime symptoms such as urgency, frequency, daytime wetting, abdominal straining or poor urinary stream, pain passing urine or passing urine infrequently.
Do not perform urine dipstick unless - bedwetting started in the last few days/weeks, there are daytime symptoms, signs of ill health are present, history of signs/symptoms suggestive of UTI or history of signs/symptoms of diabetes mellitus.
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If the child is younger than 5 years of age, ask about if daytime toilet training has been attempted. If not attempted, determine reason for this.
Look at pattern of bedwetting - night per week, times per time, quantity of urine passed, time of night, if they wake after wetting.
Fluid intake - consider diary of fluid intake, toileting habits and bedwetting.
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Home situation - is there easy access to the toilet at night, do they share a bedroom.
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Risk factors
Constipation, faecal incontinence, and daytime urinary incontinence
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Definition: Bedwetting (nocturnal enuresis) is involuntary wetting during sleep. It is generally considered to be normal in children younger than 5 years of age. It can be classified as primary bedwetting without daytime symptoms, primary bedwetting with daytime symptoms or secondary bedwetting.