Investigations
1st investigations to order
urinalysis
Test
To exclude infection, signs of renal disease, poor urine concentrating ability, or glycosuria indicative of diabetes mellitus. In monosymptomatic nocturnal enuresis, urinalysis should be normal.
Result
normal
Investigations to consider
urinary tract ultrasound
Test
Historically, no imaging was recommended in the evaluation of enuresis. However, investigation shows that ultrasound can measure bladder volume and wall thickness, which can predict underlying bladder dysfunction and poor treatment response.[30]
It is most reasonable to proceed to ultrasound if the child is initially refractory to treatment or is complaining of any other symptoms or signs of voiding dysfunction. In this setting it can be useful and should precede a full neuro-urological investigation. A thick bladder wall may correspond to detrusor hypertrophy and overactivity, whereas a thin bladder wall indicates detrusor areflexia and urinary retention.
Result
normal
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