Cardiac Arrhythmia Should Be Considered With Nocturnal Enure
Physicians doing a diagnostic workup for nocturnal enuresis, or bedwetting, appear to rarely consider cardiac arrhythmia as a differential diagnosis.

Researchers surveyed doctors about how they would approach assessment of a case of nocturnal enuresis, and only 1% reported they would order an electrocardiogram (ECG).

Survey respondents included 37 interns, 35 residents, 102 pediatricians, 57 internal medicine specialists, 42 advanced medical students, and 73 family physicians. About 33% of the respondents had more than 3 years of work experience and were classified as more senior-level medical providers. The findings suggest that doctors should consider cardiac arrhythmias as part of the diagnostic workup for patients presenting with enuresis nocturna.

Respondents were asked which diagnostic assessment they would perform on a 20-year-old asymptomatic female who had two incidents of bedwetting 2 years apart. The survey consisted of 18 questions addressing potential diagnostic workup options, including imaging tests, blood work, oral glucose tolerance test, electroencephalogram, electrocardiogram, and more, for this scenario.

Results showed that the majority of respondents said they would order a kidney ultrasound and urinalysis when encountering a patient with enuresis to identify a potential urinary disease. Physicians also noted that they would look for abnormalities in urinary flow and diabetes. Notably, only 1% of respondents considered doing an ECG, and 19% would perform an encephalogram to look for nocturnal epileptic seizures.