From the Guidelines
Laboratory tests for nocturnal enuresis should include urinalysis and urine culture as first-line investigations. These tests help rule out urinary tract infections, diabetes, and kidney problems that could cause bedwetting 1. A basic metabolic panel may be ordered to check electrolytes, kidney function, and glucose levels. In some cases, additional tests like urine calcium-to-creatinine ratio might be considered to rule out hypercalciuria. Specialized tests such as uroflowmetry or post-void residual measurements are typically reserved for cases with daytime symptoms or treatment resistance. Imaging studies like ultrasound of the kidneys and bladder are not routinely needed but may be ordered if anatomical abnormalities are suspected 1.
Key Considerations
- The evaluation of enuresis should start with a good case history, focusing on voiding habits, symptoms such as urgency, and current or previous daytime incontinence 1.
- A frequency-volume chart can provide more reliable data on voiding habits than family recollection.
- Concomitant daytime bladder symptoms or bowel habits, such as constipation, should be assessed and treated if necessary.
- Urinalysis and urine culture are essential to rule out underlying medical conditions, such as urinary tract infections or diabetes, which could be causing the enuresis 1.
Additional Tests
- A basic metabolic panel may be ordered to check electrolytes, kidney function, and glucose levels.
- Urine calcium-to-creatinine ratio might be considered to rule out hypercalciuria.
- Specialized tests, such as uroflowmetry or post-void residual measurements, are typically reserved for cases with daytime symptoms or treatment resistance.
- Imaging studies, like ultrasound of the kidneys and bladder, are not routinely needed but may be ordered if anatomical abnormalities are suspected 1.
From the Research
Laboratory Tests for Nocturnal Enuresis
The following laboratory tests are indicated for nocturnal enuresis:
- Urinalysis: This is a common initial evaluation for enuresis, as it can help identify underlying conditions such as urinary tract infections or diabetes 2, 3, 4, 5, 6
Conditions Requiring Further Testing
Further testing, such as imaging or urodynamic studies, may be necessary in certain cases, including:
- Suspected neurologic or urologic disease 3
- Voiding difficulties or excessive thirst 5
- Non-monosymptomatic nocturnal enuresis (NMNE) with additional daytime symptoms 6
Exclusions
The following tests are not typically necessary for the evaluation of nocturnal enuresis: