Basic Examination of Vande Walle et al for a Child with Enuresis

A pediatric patient with enuresis should have a basic clinical evaluation. Positive findings can help guide any further workup.

Physical Examination	Look For
height and weight vs growth curve	failure to thrive, growth retardation
lumbosacral spine	signs of spinal dysraphism (dimple, hypertrichosis, lipoma, sacral agenesis)
genital exam	hypospadias, phimosis. labial agglutination
anorectal evaluation (with or without left lower quadrant palpation)	exam of underwear for soiling, fecal incontinence, constipation
neurological exam	lower spinal cord dysfunction, CNS disorder

Laboratory Examination	Look For
urine glucose	glucosuria
urine nitrites and white blood cells	urinary tract infection
urine hemoglobin and red blood cells	hematuria
urine protein	proteinuria
urine specific gravity

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