{"id":2856,"date":"2018-10-17T19:07:36","date_gmt":"2018-10-17T17:07:36","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/raccomandazione-prof\/children-under-6-years-of-age-with-primary-monosymptomatic-enuresis-do-not-need-to-be-seen-by-a-specialist-undergo-laboratory-with-the-exception-of-urinary-dipstick-or-instrumental-testing-or-start\/"},"modified":"2019-10-02T10:25:43","modified_gmt":"2019-10-02T08:25:43","slug":"children-under-6-years-of-age-with-primary-monosymptomatic-enuresis-do-not-need-to-be-seen-by-a-specialist-undergo-laboratory-with-the-exception-of-urinary-dipstick-or-instrumental-testing-or-start","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/children-under-6-years-of-age-with-primary-monosymptomatic-enuresis-do-not-need-to-be-seen-by-a-specialist-undergo-laboratory-with-the-exception-of-urinary-dipstick-or-instrumental-testing-or-start\/","title":{"rendered":"Children under 6 years of age with primary monosymptomatic enuresis do not need to be seen by a specialist, undergo laboratory (with the exception of urinary dipstick) or instrumental testing or start pharmacological treatment."},"content":{"rendered":"<p>Primary monosymptomatic enuresis in children under 6 years of age does not require specialist treatment or specific diagnostic testing, with the exception of a simple urine dipstick test. When analysing a urine dipstick test, the possible presence of glycosuria and proteinuria should be evaluated and the specific gravity should be checked. No pharmacological treatment is necessary. What is required, however, is a detailed anamnesis of bladder function. After 6 years of age, before any eventual specialist visit, at least six months of behavioural therapy (an hour and a half before bedtime reduce liquid intake to a minimum, empty the bladder before going to bed and no drinking during the night) is recommended, together with keeping a bladder diary. Bowel function should also be corrected. If behavioural therapy should fail (at least 50% dry nights) an 8-week period of associated support therapy (enuresis alarm or 120 mcg desmopressin every evening) can be discussed with the family. The month before starting treatment, a bladder diary must be completed in order to compare results with those taken during the month after the start of treatment. If this approach proves unsuccessful (at least 50% dry nights), a specialist visit is recommended.<\/p>\n","protected":false},"featured_media":2465,"template":"","meta":{"_edit_lock":["1570004610:5"],"_edit_last":["5"],"_wpml_media_duplicate":["0"],"_wpml_media_featured":["0"],"_thumbnail_id":["2465"],"_wpml_word_count":["{\"total\":367,\"to_translate\":{\"it\":367}}"],"_yoast_wpseo_primary_eta":[""],"_yoast_wpseo_primary_disciplina":["117"],"_yoast_wpseo_primary_tipologia":[""],"wpcf-pacchetto":["SINePe #1"],"wpcf-bibliografia":["1. Neveus T1, Eggert P, Evans J, Macedo A, Rittig S, Tekg\u00fcl S, Vande Walle J, Yeung CK, Robson L; International Children's Continence Society. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society. J Urol. 2010 Feb;183(2):441-7. doi: 10.1016\/j.juro.2009.10.043. Epub 2009 Dec 14.\r\n2. Johan Vande Walle & Soren Rittig & Stuart Bauer & Paul Eggert & Daniela Marschall-Kehrel & Serdar Tekgul. Practical consensus guidelines for the management of enuresis. Eur J Pediatr (2012) Jun; 171 (6): 971\u201383 ."],"wpcf-posizione-prof":["5"],"wpcf-collegare":["N"],"wpcf-link-intercheck-prof":["N"],"wpcf-area-ordinamento":["Nephrology"],"_yoast_wpseo_content_score":["60"],"_yoast_wpseo_focuskeywords":["[]"],"_yoast_wpseo_keywordsynonyms":["[\"\"]"],"_wpml_location_migration_done":["1"],"_layouts_template":["layout-for-raccomandazioni-professionista"],"_wp_page_template":["default"],"_et_dynamic_cached_shortcodes":["a:4:{i:0;s:13:\"et_pb_section\";i:1;s:9:\"et_pb_row\";i:2;s:12:\"et_pb_column\";i:50;s:10:\"et_pb_text\";}"],"_et_dynamic_cached_attributes":["a:0:{}"],"et_enqueued_post_fonts":["a:3:{s:6:\"family\";a:1:{s:15:\"et-gf-work-sans\";s:136:\"Work+Sans:100,200,300,regular,500,600,700,800,900,100italic,200italic,300italic,italic,500italic,600italic,700italic,800italic,900italic\";}s:6:\"subset\";a:2:{i:0;s:5:\"latin\";i:1;s:9:\"latin-ext\";}s:9:\"cache_key\";s:75:\"{\"gph\":-1,\"divi\":\"4.27.6\",\"wp\":\"6.8.5\",\"enable_all_character_sets\":\"false\"}\";}"]},"eta":[{"term_id":95,"name":"Pediatric","slug":"pediatric","term_group":0,"term_taxonomy_id":95,"taxonomy":"eta","description":"","parent":0,"count":172,"filter":"raw"}],"disciplina":[117],"tipologia":"Other treatments","class_list":["post-2856","raccomandazione-prof","type-raccomandazione-prof","status-publish","has-post-thumbnail","hentry","eta-pediatric","disciplina-nephrology","tipologia-other-treatments"],"_links":{"self":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/raccomandazione-prof\/2856","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/raccomandazione-prof"}],"about":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/types\/raccomandazione-prof"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/media\/2465"}],"wp:attachment":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/media?parent=2856"}],"wp:term":[{"taxonomy":"eta","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/eta?post=2856"},{"taxonomy":"disciplina","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/disciplina?post=2856"},{"taxonomy":"tipologia","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/tipologia?post=2856"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}