Nocturnal enuresis in children.

Nocturnal enuresis (NE) can result from an interaction of unstable detrusor contractions, delayed arousal from sleep, and nocturnal polyuria. Some children with NE can hold urine well for several hours during the day and have isolated nocturnal enuresis, while others manifest diurnal voiding symptoms (DVS) as well, including urinary frequency, urgency, urge incontinence, and pelvic withholding. The pathogenesis of NE in patients with isolated NE may be different than in those with NE and DVS. In children with NE and DVS, detrusor instability may play a major role in the causation of their voiding problems, whereas delayed arousal from sleep in response to a full bladder may be a major contributor to NE in patients with isolated NE. The treatment should address the underlying pathogenic factors. The commonly used treatment regimens are described. Motivation and efforts of the child in training the bladder are vital to achieving cure of enuresis.