A 7-year-old has never been dry at night for more than two months. There are no daytime symptoms, constipation, dysuria, polydipsia, neurologic

Question

A 7-year-old has never been dry at night for more than two months. There are no daytime symptoms, constipation, dysuria, polydipsia, neurologic signs, or urinalysis abnormality. What is the best next step?

Accepted Answer

Provide education and offer a bedwetting alarm when the child is motivated

Answer

Use a reward-and-penalty program with nightly diary review to prevent wet nights

Answer

Start sedating medication to consolidate sleep and reduce wetting episodes

Answer

Start nightly antibiotic prophylaxis after urine cultures and renal ultrasound review

Answer

Order spinal MRI before starting behavioral measures for enuresis and sleep routines

Nocturnal enuresis — USMLE Step 3 MCQ

A 7-year-old has never been dry at night for more than two months. There are no daytime symptoms, constipation, dysuria, polydipsia, neurologic signs, or urinalysis abnormality. What is the best next step?