Comments on pediatric elimination dysfunctions: the Whorf hypothesis, the elimination interview, the guarding reflex and nocturnal enuresis.

Abstract

This paper addresses pediatric elimination disorders including nocturnal enuresis from the perspectives of terminology (the Whorf hypothesis), the elimination interview, and the guarding reflex. The elimination interview and a modern model of normal voiding function, including the guarding reflex, are explained. The language of voiding dysfunction influences our perception of it. Nocturnal enuresis, and all other voiding dysfunctions, should be evaluated by a careful elimination interview. The guarding reflex may fit into an evolving etiologic paradigm for nocturnal enuresis. (1) Words and phrases of eliminology should aim for simplicity, clarity and accuracy. (2) Urologists need to perfect their eliminology skills vis-à-vis the elimination interview. (3) The role of the guarding reflex in nocturnal enuresis and all other voiding dysfunctions should be critically examined.