| Topic/Area | Nocturnal Enuresis |
| Introduction | The majority of children achieve daytime and night-time continence by age 3 or 4. The condition is termed “enuresis” when there is an involuntary discharge of urine by day or night or both, in a child age 5 or older, in the absence of congenital or acquired defects of the nervous system or urinary tract. |
| Types | i. Primary Enuresis: The child has never achieved continence before. |
| ii. Secondary Enuresis: The child has been dry for at least 6 months but has started bedwetting again. |
| Type of Enuresis | Management Recommendations |
| Primary Enuresis | i. With Daytime Symptoms: Refer to secondary care or enuresis clinic for further assessment. |
| i. Without Daytime Symptoms and < 5 YO: Reassurance that the child may soon achieve continence. | |
| Without Daytime Symptoms and > 5 YO:
Infrequent (<2 times a week): Reassure Frequent (>2 times a week): 1: Long-term control required: Enuresis alarm (first-line) and reward system. 2: Short-term control required: Desmopressin for temporary control (e.g., sleepover). |
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| 3: After 2 complete courses of treatment with no success: Refer to secondary care. | |
| Secondary Enuresis | i. Refer to the paediatrics department for further evaluation and management. |
