You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 6 years male child comes with complaints of bedwetting. The child is continent during the day and problem is only at night. Growth and development of the child were normal. Urine microscopy is normal and urine specific gravity was 1.020. How will you manage? and explain in detail?
Ans: A: Reassure the parents and follow up after 6 monthsExplanation:(Ref: Nelson 20Ie p2585; Ghai 8/e p504)Bed-wetting is normal till 5 years of age.In a child with only night-time bed wetting, when urinalysis (to rule out infections) and urine osmolality (to rule out diabetes) are normal, only regular follow up is required.Treatment:To reassure the child and parents that the condition is self-limited and to avoid punitive measures that can affect the child's psychologic development adversely.Fluid intake should be restricted to 2 oz after 6 or 7 pm.Parents should be ceain that the child voids at bedtime.Avoiding extraneous sugar and caffeine after 4 pm also is beneficial.If the child snores and the adenoids are enlarged, referral to an otolarvngologist should be considered, because adenoidectomv can cure the enuresis.