Issue for Referral
- Use nonpharmacologic approaches as first line before prescribing medications (6)[A].
- Simple behavioral interventions (e.g., scheduled wakening, positive reinforcement, bladder training, diet changes)
- Enuresis alarms (bells or buzzers):
- 66–70% success rate; must be used nightly for 3–4 months; offers cure; significant parental involvement; disruption of sleep for entire family
- Primary NE: Persistent enuresis despite nonpharmacologic and pharmacologic therapies
- Diurnal incontinence or nonmonosymptomatic enuresis with voiding dysfunction or underlying medical condition
Individual psychotherapy, crisis intervention, and family therapy
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