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


urine nitrites and white blood cells

urinary tract infection

urine hemoglobin and red blood cells


urine protein


urine specific gravity



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