Diagnosis of Bedwetting
Diagnosis of nocturnal enuresis is made when involuntary urination regularly occurs during sleep in a person who is continent while awake. Determining the cause for the condition requires a detailed medical history and a comprehensive physical examination.
Medical history includes the following:
- Assessment of psychological and emotional issues
- Fluid and dietary intake (especially late in the day)
- Daytime voiding frequency and volume
- Sleep history (i.e., time the child goes to bed, falls asleep, and awakens; depth of sleep; timing of bedwetting; snoring; nightmares)
- Periods of nighttime dryness and the circumstances
Physical examination includes the following:
- Blood pressure
- Examination of the genitals
- Palpitation of the kidneys, bladder, and lower spine
- Neurological examination of the lower body including gait, muscle strength and tone, reflexes, and sensation
Various diagnostic tests may also be performed to determine the cause of bedwetting. These tests are reserved for patients in whom physical abnormality or obstruction are suspected. Urinalysis is performed to detect cystitis, UTI, urethral obstruction, diabetes, and other possible physical causes.
Imaging or other tests used to detect abnormalities may include the following:
- Cystometrogram (measures bladder pressure at various stages of filling)
- Cystoscopy (examination of the bladder using a cystoscope)
- Magnetic resonance imaging (MRI scan)
- Ultrasound
- Voiding cystourethrogram (VCUG; used to observe the urinary tract before, during, and after urination)
Other urodynamic studies, which measure the storage and rate of movement of urine from the bladder, and uroflowmetry, which measures urine flow, may also be performed.
