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79
These figures are strikingly similar to those seen and reported on
each year, over the past 6 years.
Once again, one wogld mention with appreciation, the complete
liaison and co-operation shown by the general practitioners over many
years.
III. ANALYSIS OF TREATMENT
1. GENERAL
With each child a considerable amount of time is devoted to a thorough
history taking, during which a number of constructive suggestions are made.
The approach is mode almost entirely through the child, with the Mother (or
Father) at hand to help in eliciting an accurate history.
It is encouraging to note the increasing interest and co-operation of the
Mother as the child's confidence and enthusiasm is gained.
This approach, with the added explanation of a strict routine, "lifting
system", etc. etc., coupled with instruction to the child about the charting of
all dry nights, has proved over the years, to be all important in speeding on a
"cure".
The existence of the "Pre-waking Enuretic" is now well recognised and a
period of 6 or 8 weeks of consecutive early (5 a.m.) waking by parents or an
alarm, often proves sufficient to establish a reflex waking habit.
2. SPECIFIC
(i) Of behaviour, anxiety or home problems
This aspect of the etiology of enuresis is extremely varied and of great
significance and naturally needs to be discussed and treated with diplomacy
and care - often taking up a considerable amount of "therapeutic time".
(ii) Drug Therapy
This is issued by liaison with the patient's general practitioner. The
drugs most commonly used have been:-
1. Amitriptyline
2. Imipramine
3. Dexten
4. Limbitrol - 5 (more recently)