Initial work-up for monosymptomatic nocturnal enuresis should begin with:

Initial work-up for monosymptomatic nocturnal enuresis should begin with:

• A. Urine culture
• B. Voiding diary
• C. Urinalysis
• D. Renal ultrasound

Answer: (C)

When evaluating monosymptomatic nocturnal enuresis, start by screening the urine with a urinalysis. This quick, noninvasive test helps rule out conditions that would change management, such as a urinary tract infection, diabetes (glucosuria), or kidney disease (proteinuria or hematuria). If the urinalysis is normal, most children have no underlying pathology and enuresis can be addressed with behavioral approaches and enuresis-specific therapies (like a moisture alarm or desmopressin) as appropriate. A voiding diary can be useful afterward to assess nocturnal urine production and bladder capacity, and imaging like a renal ultrasound is reserved for atypical features or persistent, non-monosymptomatic findings. A urine culture is only indicated if there are signs or symptoms suggestive of a UTI.

When evaluating monosymptomatic nocturnal enuresis, start by screening the urine with a urinalysis. This quick, noninvasive test helps rule out conditions that would change management, such as a urinary tract infection, diabetes (glucosuria), or kidney disease (proteinuria or hematuria). If the urinalysis is normal, most children have no underlying pathology and enuresis can be addressed with behavioral approaches and enuresis-specific therapies (like a moisture alarm or desmopressin) as appropriate. A voiding diary can be useful afterward to assess nocturnal urine production and bladder capacity, and imaging like a renal ultrasound is reserved for atypical features or persistent, non-monosymptomatic findings. A urine culture is only indicated if there are signs or symptoms suggestive of a UTI.