DrVirgo
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A mother brings her 4-year old son to see you. She seems to be very concerned about her child's bedwetting. As you explore the history, the mother tells you that she started his toilet training when he was 2-years old. The child responded to his mother's efforts and slowly was able to reduce the frequency of bed-wetting. However, he did not completely succeed and still occasionaly wets his bed. She has become so concerned that she demands you to order tests and prescribe some drugs to resolve the problem. What is your best next step in the management of this boy?
A. Immediately do an ultrasound, IVP, and cystometrogram to establish a baseline level of functioning
B. Start a desmopressin for incontinence and antibiotics for the child's UTI
C. Do a KUB and then check for vesico-ureteric reflex
D. Do urinalysis followed by culture and microscopy
E. Advise a calcium channel blocker and bell pad system with stricter toilet training
F. Reasure the mother that everything is normal and it will resolve with age.
Please explain your answer. Thanks. 
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| new_n_lost
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D. Urinalysis . Initial step in ruling out Primary n Secondary causes of NE
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| robin082006
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F. Reasure the mother that everything is normal and it will resolve with age.
<5yo, gradual response to training (slowly was able to reduce the frequency of bed-wetting), occasional enuresis------>reassurance
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| 92306
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F. Reasure the mother that everything is normal and it will resolve with age.
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| DrVirgo
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Bedwetting is considered "normal" before the age of 5, so F is right. Reasurance.
Now go take your exam! 
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Our greatest glory is not in never falling, but in rising every time we fall.
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