Ed 11 Chapter 143 : Functional Disorders of the Lower Urinary Tract in Children

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A 9-year-old female presents to the office with a chief complaint of daytime urinary incontinence. She denies dysuria, hematuria, or enuresis. She has never had a urinary tract infection (UTI) and there is no history of hydronephrosis. Her mother states that toilet-training occurred at 2 years of age and was “easy.” A clean-catch urinalysis has been obtained by her pediatrician and is completely normal. When characterizing the incontinence, she states that she completely soaks her clothes, necessitating a change in wardrobe. She denies urgency or frequency and otherwise voids every 2 to 3 hours during the day. She states that the episodes are often associated with laughing at a funny joke or movie. She denies any issues with constipation. Assuming physical examination and voiding diary are normal, which of the following would be a reasonable first-line treatment strategy?

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