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Table 2 Important physical examination and urinary test findings in children with enuresis

From: Practical consensus guidelines for the management of enuresis

Strategy Observation/test To check for
1 (minimal) Body weight and height Growth retardation and/or failure to thrive suggestive of an underlying disorder
1 (minimal) Genital examination—including examination of underwear Physical abnormalities: hypospadias, phimosis, labial agglutination. Signs of fecal incontinence
1 (minimal) Inspection of lumbosacral spine Occult spinal dysraphism: dimple, lipoma, hypertrichosis, or sacral agenesis
1 (minimal) Urine dipstick test Glycosuria, infection (leucocyturia, nitrite test), hematuria, and proteinuria
2 (extended evaluation) Rectal palpation if acceptable for child, parent/care giver Fecal masses; left bowel palpation may be more acceptable to family
2 (extended evaluation) Neurological examination (size, tight heel cords, hammer, or claw toes) Signs and symptoms suggestive of lower spinal cord dysfunction
  The neurologic exam should include assessment of posturing with a stress gait or mirror movements CNS abnormalities suggestive of a central cause
  1. CNS central nervous system