1. TRY for DRY Healthcare Training Instructor Max Maizels, MD Division of Urology Children’s Memorial Hospital – Chicago Professor of Urology Northwestern Medical School Managing Enuresis www.TRYforDRY.com

2. Is our wide policy of laissez-faire because: PEDIATRIC ENUROLOGY - we believe it is unnecessary to treat proactively ? treatments of bedwetting are no good, so why bother with fuss and expense ? we haven't been trained to, so, we don't know how ?

3. AGEENURESIS (%) 340 430 520 610 87 123 181 PREVALENCE OF BEDWETTING AMONG AMERICAN CHILDREN B. Schmidt Your Child's Health 1987. PEDIATRIC ENUROLOGY

4. Mostly pediatricians & family practitioners Plus A few urologists A few social workers and A few physical therapists PEDIATRIC ENUROLOGY Personal survey of 80 professionals:

5. PEDIATRIC ENUROLOGY Most of these healthcare providers have never even had informal instruction in addressing this problem.

6. Personal survey of 80 professionals: PEDIATRIC ENUROLOGY Major treatments used: Tofranil Alarm DDAVP

7. Popular Treatment Approach patience --- “..it isn't important, you'll outgrow it.” PEDIATRIC ENUROLOGY Personal survey of 80 professionals:

8. Most had never personally held an enuresis alarm!! PEDIATRIC ENUROLOGY Personal survey of 80 professionals:

9. MANAGEMENT PATTERNS 1 o CARE PHYSICIANS NIGHT ALARM PEDIATRIC ENUROLOGY REFERS TO PSYCHOLOGIST EVALUATE ONLY AFTER FAMILY MENTIONS 50% SUCCESS RATE WITH DDAVP, BUT FEARFUL TO STOP MED RESTRICT NIGHT LIQUIDS

10. MANAGEMENT PATTERNS 1 o CARE PHYSICIANS IF TREATMENT DOESN’T INVOLVE SURGERY, PEDIATRIC ENUROLOGY BUT IT IS THE JOB OF THE URLOGIST TO ENGAGE PEDIATRICIANS. PATIENT SHOULD NOT NEED TO SEE A UROLOGIST….

11. No Accepted Method to Evaluate and Manage Routine Bedwetting So Most Parents Just Ask Each Other. PEDIATRIC ENUROLOGY Before TRY for DRY

12. DRYNESS IS JUST NOT AS EASY AS... TAKING A TABLET

13. DRYNESS IS JUST NOT AS EASY AS... TAKING A PUFF

14. Rubber pants… until you learn, kid. until you learn

15. TRY for DRY Help for Physicians and Parents

16. Close Screen and Return to Lesson