A 7-Year-Old Boy Comes to the Office with His Father

A 7-year-old boy comes to the office with his father due to nighttime bed wetting.  The patient was daytime toilet trained by age 2 but has continued to wet his bed about 3 nights a week, leading to several canceled camping trips.  The patient urinates 5 or 6 times during the day and has no urgency or dribbling.  He has a soft bowel movement every day.  His father achieved nighttime dryness at age 9.  Medical history includes attention deficit hyperactivity disorder that is treated with lisdexamfetamine.  The patient is seeing a speech therapist for stuttering and has struggled with low self-esteem.  He was born at 34 weeks due to non-reassuring fetal heart tones.  Growth and development have been on track.  Vital signs, examination, urinalysis, and urine culture are normal.  Which of the following is the greatest risk factor for this patient's nighttime bed wetting?

A) Attention deficit hyperactivity disorder
B) Family history
C) Low self esteem
D) Premature birth
E) Stimulant intake

Correct Answer:

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