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Urology

Primary urinary enuresis (or bedwetting) is defined as urinary incontinence during sleep in a child older than what age?

A. 2 years old

B. 3 years old

C. 4 years old

D. 5 years old

Answer: D

By age 5, children are expected to have both daytime and nighttime dryness. Primary nocturnal enuresis is defined as intermittent urinary incontinence in children older than 5 years old.

References: Baird DC, Seehusen DA, and Bode DV. Enuresis in Children: A Case Based Approach. Am Fam Physician. 2014;90(8):560-568. Pubmed ID: 25369644.

Ramakrishnan K. Evaluation and Treatment of Enuresis. Am Fam Physician. 2008;78(4):489-496,498. Pubmed ID: 18756657.

What is the prevalence of primary nocturnal enuresis in all 7-year-old children?

A. Less than 5%

B. Between 5% and 10%

C. Between 15% and 20%

D. More than 25%

Answer: B

Approximately 5% to 10% of all 7-year-old children have primary nocturnal enuresis (PNE or bedwetting).

Reference: Baird DC, Seehusen DA, and Bode DV. Enuresis in Children: A Case Based Approach. Am Fam Physician. 2014;90(8):560-568. Pubmed ID: 25369644.

Which of the following behavioral interventions should not be used in the management of bedwetting?

A. Punishing the child

B. Limiting fluid intake two hours before bed

C. Encouraging voiding before bed

D. Enuresis alarm therapy

Answer: A

Behavioral interventions for primary nocturnal enuresis or bedwetting including limiting fluid intake before bed, encouraging voiding before bed, and enuresis alarm therapy (an alarm that is triggered by moisture and awakens the child) may be used in the treatment of bedwetting. Children should not be punished or made to feel guilt or shame over bedwetting.

References: Baird DC, Seehusen DA, and Bode DV. Enuresis in Children: A Case Based Approach. Am Fam Physician. 2014;90(8):560-568. Pubmed ID: 25369644.

Ramakrishnan K. Evaluation and Treatment of Enuresis. Am Fam Physician. 2008;78(4):489-496,498. Pubmed ID: 18756657.

Which of the following medications should not be used to treat bedwetting in children?

A. Oxybutynin

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