Elimination Disorders: Diagnosis

Elimination disorders are characterized by failure to obtain or maintain continence as developmentally expected.


Enuresis is defined as the persistent inappropriate passage of urine beyond 5 years of age, regardless of whether it is considered intentional or unintentional. For clinical diagnosis, this behavior must manifest regularly for at least 3 consecutive months or present significant impairment across domains. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), specifies that enuresis can be categorized as nocturnal (occurring only at night), diurnal (only during the day), or both. The International Children’s Continence Society adopted two terms: (1) enuresis, referring to nocturnal occurrence only (i.e., bed-wetting), and (2) incontinence, which is restricted to daytime occurrence. A child with inappropriate urination during both day and ...

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