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21.6 Nocturnal Enuresis

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Enuresis is bedwetting after the age of 5 years. It is a benign condition which mostly resolves spontaneously. It is important, however, to differentiate between nocturnal enuresis and enuresis during daytime with associated bladder dysfunction. Secondary causes of enuresis include:

  • diabetes mellitus
  • urinary tract infection
  • physical or emotional trauma

Note: Clinical evaluation should attempt to exclude the above conditions. Urine examination should be done on all patients.

Non-pharmacological treatment

  • Motivate, counsel and reassure
  • Spread fluid intake throughout the day
  • Psychotherapy

Pharmacological Treatment

A: Imipramine 25 mg nocte for on month

OR

S: Oxybutynin (PO) 5mg 8 hourly for one month

Referral 

  • Suspected underlying systemic illness or chronic kidney disease
  • Diurnal enuresis
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