achilles
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A 7-year-old boy is brought to the clinic for a lifetime history of bedwetting. He has otherwise been completely healthy and has met all development milestones. His parents deny a history of trauma, and the history is not consistent with abuse. The patient has been wetting every night but not during the daytime. He has no incontinence. Which of the following is the most appropriate next step in his evaluation?
A. Intravenous pyelogram
B. Renal ultrasound
C. 24-hour urine collection
D. Urinalysis
E. CT of pelvis
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| DrS
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D. Urinalysis
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| achilles
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that's right DrS, but do you know the reason for that...is it because they want to rule out infections first...i knew the answer but not the reasoning...
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" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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| DrS
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Well the urinalysis can give you lots of information regarding possible causes of nocturnal enuresis. Certainly infections (WBCs in urine) are one of them, but in addition it would give clues regarding diabetes mellitus (glycosuria), diabetes insipidus (can be excluded if specific gravity > 1.020) etc.. therefore it is considered the first line investigation in nocturnal enuresis.
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| achilles
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thanks DrS.i really appreciate that.you made it more clear to me.
___________________
" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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| DrS
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Posts: 338
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Youre welcome achilles 
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