A 5 year-old girl is referred for evaluation of bed-wetting. The mother states that her daughter has never fully gained control of her bladder. It took her an extended period of time to grow out of diapers and the girl has finally stopped having "accidents" during the day. However, she continues to wet her bed at night. The patient has developed normally in all other aspects and will be staing kindergarden in three months. Both her mother and father are extremely frustrated and have been losing sleep, as the girl wakes up at night 4 to 5 times per week. Physical examination is unremarkable. Which of the following will most likely be the result of fuher investigation?
Enuresis was originally denoted as incontinence of urine, but now, it is a term restricted to those children who are over the age of 3 who wet the bed. Most children have achieved normal bladder control by that time, girls earlier than boys. At age six years, 10% have enuresis. It is impoant to rule out other possible causes of enuresis, but usually, investigation will reveal only normal results. It is believed that up to 50% of cases are caused by delayed maturation of the nervous system or intrinsic myo neurogenic bladder dysfunction. 30% are of psychologic origin and 20% are secondary to more obvious organic disease. The bladder capacity of bed wetters and non-bedwetters is the same. The difference is that the non-bed wetters are able to hold their urine in their bladders throughout the night. When compared with normal children, the majority of children with bedwetting problems score just as well on tests of intelligence and school achievement. These children are no more likely to suffer from permanent neurological abnormalities, poor school achievement, low IQs, or severe learning disability. It is true that bed-wetting children are more likely to get urinary tract infections if their personal hygiene is poor; it is not true that such infections are the main cause of bedwetting.
Large capacity bladder
Learning disability
Normal
Urinary tract infection