Monosymptomatic nocturnal enuresis (MNE), defined as nocturnal bedwetting in children without daytime lower urinary tract symptoms, is a frequent concern in general pediatric practice. It is common in early childhood and typically resolves spontaneously with increasing age, indicating a strong maturational component. Nevertheless, MNE is often conceptualized as a pathological disorder requiring active medical intervention. This mini-review proposes that MNE may be more appropriately interpreted as a developmental variation reflecting delayed maturation of nocturnal arousal mechanisms rather than a primary structural disorder. From a developmental perspective, nocturnal urine production, bladder storage capacity, and sleep–arousal mechanisms mature at different rates, and enuresis occurs when arousal maturation lags behind other components. Current therapeutic approaches mainly provide symptomatic control or facilitate adaptation rather than correcting a structural abnormality. Reframing MNE within a developmental framework may help support reassurance, shared decision-making, and more balanced clinical discussions regarding management in routine pediatric practice.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> What is Known: • Monosymptomatic nocturnal enuresis (MNE) is generally regarded as a functional disorder related to delayed maturation of nocturnal continence mechanisms. • Multiple factors, including nocturnal urine production, bladder capacity, and sleep–arousal function, contribute to the pathophysiology of MNE. What is New: • This article proposes that MNE may be better understood as a developmental variation caused by temporal mismatch among continence-related maturation processes, particularly sleep–arousal maturation. • The developmental perspective presented here may help reduce unnecessary medicalization and promote a more individualized understanding of children with MNE. </entry> </row> </tbody> </tgroup> </Table>

Rethinking monosymptomatic nocturnal enuresis as a developmental variation

期刊论文
发表日期：

2026年5月25日

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Osamu Uemura

摘要

Monosymptomatic nocturnal enuresis (MNE), defined as nocturnal bedwetting in children without daytime lower urinary tract symptoms, is a frequent concern in general pediatric practice. It is common in early childhood and typically resolves spontaneously with increasing age, indicating a strong maturational component. Nevertheless, MNE is often conceptualized as a pathological disorder requiring active medical intervention. This mini-review proposes that MNE may be more appropriately interpreted as a developmental variation reflecting delayed maturation of nocturnal arousal mechanisms rather than a primary structural disorder. From a developmental perspective, nocturnal urine production, bladder storage capacity, and sleep–arousal mechanisms mature at different rates, and enuresis occurs when arousal maturation lags behind other components. Current therapeutic approaches mainly provide symptomatic control or facilitate adaptation rather than correcting a structural abnormality. Reframing MNE within a developmental framework may help support reassurance, shared decision-making, and more balanced clinical discussions regarding management in routine pediatric practice.

What is Known:

• Monosymptomatic nocturnal enuresis (MNE) is generally regarded as a functional disorder related to delayed maturation of nocturnal continence mechanisms.

• Multiple factors, including nocturnal urine production, bladder capacity, and sleep–arousal function, contribute to the pathophysiology of MNE.

What is New:

• This article proposes that MNE may be better understood as a developmental variation caused by temporal mismatch among continence-related maturation processes, particularly sleep–arousal maturation.

• The developmental perspective presented here may help reduce unnecessary medicalization and promote a more individualized understanding of children with MNE.