nocturnal enuresis (findings from history and possible explanation/diagnosis)
Last reviewed 04/2022
- NICE have outlined findings from the history of a child with nocturnal enuresis (bedwetting) and possible interpretation of that history
| Findings from history | Possible interpretation |
| Large volume of urine in the first few hours of night | Typical pattern for bedwetting only |
| Variable volume of urine, often more than once a night | Typical pattern for children and young people who have bedwetting and daytime symptoms with possible underlying overactive bladder |
| Bedwetting every night | Severe bedwetting, which is less likely to resolve spontaneously than infrequent bedwetting |
| Previously dry for more than 6 months | Bedwetting is defined as secondary |
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Any of these may indicate the presence of a bladder disorder such as overactive bladder or more rarely (when symptoms are very severe and persistent) an underlying urological disease |
| constipation | A common comorbidity that can cause bedwetting and requires treatment |
| soiling | Frequent soiling is usually secondary to underlying faecal impaction and constipation which may have been unrecognised |
| inadequate fluid intake | May mask an underlying bladder problem, such as overactive bladder disorder, and may impede the development of an adequate bladder capacity. |
| Behavioural and emotional problems | These may be a cause or a consequence of bedwetting. Treatment may need to be tailored to the specific requirements of each child or young person and family. |
| family problems | A difficult or 'stressful' environment may be a trigger for bedwetting. These factors should be addressed alongside the management of bedwetting |
| practical issues | Easy access to a toilet at night, sharing a bedroom or bed and proximity of parents to provide support are all important issues to consider and address when considering treatment, especially with an alarm. |
Reference:
when to consider the possibility of child maltreatment as the cause of nocturnal enuresis