This episode is the fourth monthly Q&A installment of The Virtual Curbside podcast, produced by the Utah AAP. Host Paul Workus introduces the format where listener questions are posed to returning guest Glenn Lau, a pediatric urologist. The discussion begins with toilet training, focusing on how holding behaviors can cause future bladder dysfunction like incontinence and overactive bladder, with recommendations for timed voiding using reminders. Next, they address infrequent nocturnal enuresis in older children, suggesting on-demand desmopressin for situational use during events like sleepovers, while noting that non-responders have limited options. A related question explores tapering desmopressin in teens reluctant to stop due to fears of relapse, with Glenn advising a two-week medication vacation before appointments to reassess needs. The conversation shifts to psychological factors, where sudden onset of wetting after a period of dryness may indicate stressors or trauma, serving as a red flag for deeper issues. Finally, pharmacological treatments are compared, with Glenn explaining that imipramine isn't first-line due to its side effect profile but can be used if tolerated, though desmopressin and oxybutynin are preferred. Glenn shares his clinic's contact number for further consultations and thanks the host, ending with promotional reminders for the podcast. The episode maintains an educational tone throughout, structured as a straightforward interview with clear, practical advice for pediatric providers.
