Editing Enuresis (section)

== Diagnosis ==
Clinical definition of enuresis is urinary incontinence beyond age of 4 years for daytime and beyond 6 years for nighttime, or loss of continence after three months of dryness.<ref name="ghai">{{cite book | vauthors = Ghai OP, Paul V, Bagga A | date = 2009 | title = Essential Pediatrics | edition = 7th | publisher = CBS Publishers & Distributors Pvt Ltd. | pages = 22–41 | isbn = 9788123917771 }}</ref>
Current [[DSM-5]] criteria:
* Repeated voiding of urine into bed or clothes (whether involuntary or intentional)
* Behavior must be clinically significant as manifested by either a frequency of twice a week for at least three consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.
* Chronological age is at least 5 years of age (or equivalent developmental level).
* The behavior is not due exclusively to the direct physiological effect of a substance (such as a diuretic) or a general medical condition (such as diabetes, spina bifida, a seizure disorder, etc.).
All these criteria must be met in order to diagnose an individual. Generally, healthcare providers may further investigate for bladder control issues if a child is still enuretic in the daytime by age 4, or if they are still enuretic at nighttime by age 5 or 6.<ref name=":6" />

=== Classification ===
The International Children's Continence Society (ICCS) has developed the following standard terminology:<ref>{{Cite report |last=Erdem|first=Erim | name-list-style = vanc |date=2014-09-19|title=Faculty Opinions recommendation of The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society.|doi = 10.3410/f.718270635.793500042 |website=Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature |doi-access=free }}</ref>
* Primary enuresis refers to children who have never been successfully trained to control urination.<ref name="LMCC" />
* Secondary enuresis refers to children who have been successfully trained and are continent for at least 6 months but revert to wetting in a response to some sort of stressful situation.<ref name="LMCC">Chowdhury SH, Cozma AI, Chowdhury JH. Incontinence – Child. Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I. 2nd edition. Wolters Kluwer. Hong Kong. 2017.</ref>

There are 2 categories of enuresis:
* Monosymptomatic enuresis (MNE) – Does not include bladder dysfunction during daytime.<ref name=":2" />
* Nonmonosymptomatic enuresis (NMNE) – Includes bladder dysfunction causing daytime incontinence that is frequent and urgent.<ref name=":2" /> Wetting that occurs in the daytime is sometimes referred to as [[diurnal enuresis]].<ref>{{Cite web|title=Daytime Wetting (Diurnal Enuresis)|url=https://www.cincinnatichildrens.org/health/d/wetting|access-date=2020-08-03|website=www.cincinnatichildrens.org}}</ref> Other conditions, or [[Comorbidity|comorbidities]], that commonly accompany enuresis may be expected to be more common with NMNE.<ref name=":3" />