pl. enureses [Gr. enourein, to void urine]
Involuntary discharge of urine after the age at which bladder control should have been established. In children, voluntary control of urination is usually present by 5 years of age. Nevertheless, nocturnal enuresis is present in about 10% of otherwise healthy 5-year-old children and in 1% of normal 15-year-old children. Enuresis is slightly more common in boys than in girls and occurs more frequently in first-born children. This condition has a distinct family tendency.
SEE: nocturnal enuresis; SEE: bladder drill
When no organic disease is present, the use of imipramine as a temporary adjunct may be helpful. This is usually given in a dose of 10 to 50 mg orally at bedtime, but the effectiveness may decrease with continued administration. The bladder may be trained to hold larger amounts of urine. This procedure has decreased the occurrence rate of enuresis. No matter what the cause, the child should not be made to feel guilty or ashamed, and the family and the child should regard enuresis as they would any other condition that lends itself to appropriate therapy. If the child tries too hard to control the condition, it may worsen. Conditioning devices that sound an alarm when bed-wetting occurs should not be used unless prescribed by a health care professional familiar with the treatment of enuresis.
Imipramine is not recommended for children under 6 years of age. Blood counts should be taken at least monthly during therapy to detect the possible onset of agranulocytosis.
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