Diagnosis and management of nocturnal enuresis

The etiology of primary nocturnal enuresis remains somewhat controversial but may include genetic factors, decreased functional bladder capacity, increased diuresis at night, and constipation. Deep sleep and emotional illness usually play only a minimal role. A detailed description of the enuretic episodes should be obtained, and a neurologic examination should be performed as part of the physical evaluation of a child with nocturnal enuresis. In uncomplicated cases, urinalysis and a urine culture are the only required laboratory tests. The specific cause of the nocturnal enuresis usually is not determined. Treatment options include the urine alarm system, pharmacotherapy and complex regimens such as dry-bed training. Treatments are often combined. Nocturnal enuresis eventually resolves in the majority of cases.