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3) ) Elimination
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Definitions
Enuresis refers to the wokrotary or tetectiocal voice
oP rice.
Primary enuresis: child never established
urinary continence.
Secondary enuresis: occurs after a period
of urinary continence(roughly six months or
more).
Diurnal includes daytime episodes.
Nocturnal includes nighttime episodes.
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0 Dre potat prevdlewse وا لا یت DGO-1O-DR are
°P pervedt oF boys onl 9 pervect of yids ut GS pears of age,
9 perved of boys ond O pervect oP yids by IO pears oP ace:
Ody 0 percedt oF boys stil wet ot age JO pears of age, ood stil Paver is
wet ot this oe.
© Primary Couresis: Ode predowiccae, ضيه علدب جوج دصل
0 Gevowdey Couresis: Osudly equal ta bok.
© Orwers 9% und O% vf school oye yids expericwe dovie
جصمج وا رونت
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مت اه جام و مه و OGO-10-TR dso cies
وه ۲اه ور 9 اه مه و موم 4106 له مسسم ©
Geovadary براجت نوم قحا جوملا رجه ك وه روت وه
beqjus betwerd S pears oP age und © peas oP جه
QOvutd disorders ure presedt 1 CO% vf patients.
ed Orting > جنس مرول
Dypicd voours OO wisutes to O hows oPter sleep اجه
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oP chien wits Pouresis (particu) boys) bave 1 ۹۵ :لماص
deqrer retoive Puontiogal eouresis.
Octwratizcal *توعكصاصاع .
Ovatowird abuorwutiies vr ONG
Crete teovutceure
Dedicatiogs
Cpidewivloyir studies kave shows ای و betwers psychological
dsturbouwe ocd ecuresis.
Lick to exrvtiocal disturboaes.
rates oP bebaviord problews((Duxtety states, Opposincntliy, نا
COW)
Gevowkey Couresis related to stress, trou, or psychological prisis pr
اه ...
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75% risk where both parents
have been enuretics as children
PP) 45% isk wher only one parent
4!) has been enuretic
15% risk where there
is no parental history
of enuresis
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repected void oP urice duro the doy or ot cight toto bed or clothes
Uhether tovchuatary or ietectiocraty
the behavior is vloicdly siqaiPiccdt os wooested
cu Prequeuny oP ot beast twice per week Por ot feust three couse cuiive
woot
or kypuiredt io socid, acadewic (oecupuived) or viher iportot
".موسا خم جوضن
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0۵0-۳1017 م0 )0 ۳)
©. Repeated verde of orice hiv bed or coker (whether Ruckntary or Kiecirad).
©. Phe behavior ip chicdly okmPocdt cs wraaPested by o Prequeay of ture a werk Por ot
fet O creer ive سس تون preseure of یطوط راو or راهم مس
exis (pom urdiond), or cher keportact areas of Puactckny.
O. هه لام of cet S pare of axe (or equivdet developarrcid evel).
©. Phe behavor © wet he اه سوام تس سا و of ریدم) لو و u hires) or 3
second weded rntics (e.., dobetes, spat bide, ov a setzure deorder).
ype: سوه
باه مهو(
Onur oo
Oorturcd ced choco
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عوویه۲) وم و() سا تمعن عصرم()
عوجر 9 با و وه ولج ماو حلاو ۱۳۰ .ظ),
۱
لا pourger thao “P pears oP age ord of eust gare لاه دا مت و “Po years of age or
و
۱), ۲۳۲ اوه ان همجن و او ها موه utacks or oP aeurdogicd iaovoitceace ord & ot
مرو ان رو سس ما تووویی سا خان ا هم وووواه ام مجموه اه و اس و
له ال
۵ مه بت جا و oP oy other peyohiairic disorder that wets the oiterta Por other IOO-
AO rxteypries
.. Qurctica oP the disorder ts of least 9 wvuhe
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تاه متا رد روم us vbstructive اس امن نوتمه
ad petits
Onbetes weltius.
Getwes, od side ePPevis of wedicuiva, suck os catipsychotios or
hhuretios
Oeruuse utcary trod iePevioes coo produce esuresis, ounces should
be port oP every evaluation. Ostey radiographic procedures wis pootrast
wedho ty detent oo ocaizeicdl or physiclogicd ore twosive ved poioPul, ocd
the dhaapste vied t bw.( 9.2%)
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* و موه رای ore Prequed betwerd O ood © peus
uid puberty.
rivary: high spootcoevus rewission,
* Geooaday: Osuly begics bh ages G-O pews.
° Odolesvedt coset siqaihy wore psychiatric problews ud less
Favorable vuteowe.
Cowplcaivg tochide ewbharusswed, arger Pow ont pucishkweat by
طلست روم برط موه ,وه ور oF overnight visits ord
۱ any vulbursts.
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۱2 Ger een eee)
ye oF chil
QOeded couse has bero rued ut
Rate oP spoutcevus rewssiva
@ekaviord coodiccicgy wih bell ced pod رالات اه
— Cqunly ePPevive os phornworviyiod ireokrent
— bower rote oP relapse too with: phocwarddedicd treater
— @xPer thon pharnwacvlyicd treakreot
موسوم لح ره بو inervecion ts Deswopressia aretae (DDPOP)
Oost servos side ePP ert (rove) is hypeodtrewin, beady to یه
ها او a7 Imager Pirstice choice Por phorwacoloyicd treater, but cod be used Por
له رها
Corebieatica of bebaviord ام اجه apoyo” reared cao be aocsidered Por رخا
اد «
سح سوه اسك طاة عصخححصا بصو سوت با له مس Qekaviord
واه مهم
۳ bell ced pod ceted of او وه او مت موس و وولو oP
78%,
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© General measures :
- Restrict fluid intake 3-4 hours beforebedtime.
- Empty bladder before rej
-Keep a chart of wet and a
- Reward for dry nights. ¥
-Avoid punishment/critic!
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A. Behavioral therapy such as buzzer that
wakes child up when sensor detects
i / _ر
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B. Psychotherapy not an effective treatment alone,
but can be useful in dealing with coexisting
psychiatric problems and emotional and family
difficulties
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Cc. Pharmacotherapy include antidiuretics (such as
desmopressin) or Tricyclic antidepressant (such as
imipramine)
v
نم و
* Dost chides respod ia the PG- ty WEG-ry rere.
° © boselee elevirovandoqracn shoud be اس شا لها لاه
wily ieipraice, cod wouioriog is advised above © .© الب
°° rekatioa ty bled level!
© Dke storrdard wart feat Por dosage is G wey body weigh.
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لهاك
2000
۶ ویو researck toto treater Por rouresis wolves the اه و 000
Review Grades: (0%-O0% success rote
coe the wedicatios is عمج بو وی و
rewutced dry.
us vay SP % هجو
Dke wost coww0s side ePPevts were cosd stuPPicess, headache, epistaxis, ood
موه ار pai.
Coxpbieation wits bekavioral wetkods works better.
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° Cuvoprests | repecied pussaye of Peces ivio ام موه
* atleast voce o wok Por ot east OD اموب
* the weotd or امه age oP the chit oust be ot feust P peas
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Prevalence is about 1% of 5-year-old children.
Prevddeuse decreuses with age
© siqeiPhiccdt relotiod betueed euoopresis wed eouresis hos
معا مه Poured
Gcbkool age! Dule> Pewdle: C.G:0-0:0
Wiser votes ic OR ced Low soviverourwir chosses.
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Etiology
* Constipation with overflow incontinence can be
caused by nutrition; structural disease of the anus,
rectum, or colon; medical side effects; or endocrine
disorders.
Children without constipation and overflow
incontinence often have lack of sphincter control.
Inadequate training or Emotional issues.
Emotional stress also may trigger encopresis. A child
may experience stress from premature toilet training
or an important life change — for instance, the
divorce of a parent or the birth of a sibling.
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OGO-10-TR Orccawstc Criterta Por Gacopresis
0. Repeated passer oP Peoes kip keppropriie pares اوه ری or Poor) wheter
بصم اسم or kicctrd
0. @tleast coe suck مرو a wrk Por of becst O wrath
pears of axe (or eqaideat devebpwrectd evel) ® ماه جا جيب مپسا(
0. Phe behavior is ot exctisively due to the direct physicloyicdl ef Pevis oP o substaace ),
Uknvtives) or yecerd weded coudiivg, except through o wevhuaise voles mcstizatic:
(Onde as Polos
وه وله ای رای زط)
ی تاه له ماه تمازط
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a
Oicxpwsir Criteria Por Ovowrceiz 2 طاو روص
©. Dh 3 سم ۲ موه نا ار ما موم رآ (ear,
یه وه چاه نون لبط )رم و را لا و اه
ما متخ و زورمین (
(0. ۳ وه ای له موه جلله te ot east P pears oP oe
.O. Vhere 6 ot ewst vor europretic evedl per عادصب
.0( . Qurctica oF the disorder ts ot beast O ای
AB. Shere is oo مس coodica thot cvosttuies 0 suPPidect couse Por the وه موس
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Ovpelbwesicgiocele *
؟ تسوا اس بطم مساو
Rect stewsis
Oud Fissure ۴
Oud tna °
uxiety or Phobia *
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له ,مرو علا ۲اه روط عا رصصجه عا مه مرول من ۶
voexistog behavior problews.
® Os coses a seP-icviticg, rarely cvoticuiag beyood wid
CS % ov worbid وه
®) @spchiaiic or wediod o-worbidiy: war deterxpiccat رو وه
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موست ان و66
(سس (sore مسا
Ovwrtecive
Ootioca (lecst Precuect)
© honak hetory & esseutd ba doouceus Prequewy, cure, ood
ام oP ev
iret hoe مج چاه Por reteuive subtype امه رای
(Bducation cbout bowel Purity wits bok parecer orn chil
wits knees or coker ol موس لوط
Orkwiord cowpooedt wi ite titervals 70 tle cod postive reicPorce wet
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2
YD ke wost widely accepted Pirst hur of treukpedt is poe موی
لو موه امه ماه جر وا مرو Dke wool of ۷
اه ارو
Y Edurattag the chit ood Rasiy obout the disorder is carter ieportoct pod
DP treukvet.
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Sond واصصيه desiqaed ده ها bots he pores يجيه اداح لحي
bowel Puoctico ood to dPPuse the psychologic teasiva thot way hove
developed to the Pocoiy occu the eucopresis.
the chitt receives chy ارت اه ,واه انوا اه نم دق که
doses of kasatives pr cicerdl ol.
° Dhere لوصوو تمت اممو فحاصتا ه ها فطل te the ireakved, whirk اوه
OP daly teed tatervals oo the tollet wi: rewards Por success
0 PO% sucess rate
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°° Dhere ore severd wethods Por روا he ool ood retevicg
:ولس اعد سكج ااعمكمج
لها عه اس ,وا امن ٠١
لاه اس جه اصی روا واون ...رز
fi, (Recta suppositories
جوا .با
2 Dore orc Phuicds
* Phonweovlodicd treokvedt wik imipeanice ds kas bers reported or
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