Clinical Management of Nocturnal Enuresis

Bedwetting is a common chief complaint for patients presenting to primary care and urology as well as nephrology practices. Although nocturnal enuresis caused by anatomic and/or physiologic pathology is uncommon, monosymptomatic nocturnal enuresis can still be a source of significant stress and result in quality-of-life concerns. Accurate evaluation and management of these patients will ideally result in a notable increase in quality of life and assurance of overall wellness.

Persistent nocturnal enuresis is thought to be closely associated with deep sleeping patterns, and thus treatment with bedwetting alarms provides the best statistical opportunity for accelerated resolution of bedwetting. Pharmacotherapy options, namely, desmopressin, can provide temporary symptomatic relief which may be important in reducing anxiety related to bed-wetting based on social situations. Alternative therapies are likely worth exploring for patients without a notable response to initial treatment and concern or worry about the presence of nocturnal enuresis.

A significant volume of pediatric patients presenting to primary care and pediatric urology and nephrology practices will have voiding/enuresis-related chief complaints, and a notable proportion of these have monosymptomatic nocturnal enuresis. A thorough initial evaluation and implementation of targeted therapies can effectively enhance the quality of life for the patient and their families.