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  • The Review Course in Family Medicine

Conquering the Night: A Guide to Managing Enuresis in Children

Enuresis is a common concern for many children and families. Here are a few tips to guide your


  1. Differentiate between nighttime episodes (monosymptomatic) vs presence of daytime symptoms/ lower urinary tract symptoms (LUTS) which requires further workup

  2. Previously ‘dry’ children should be screened for organic causes (i.e. constipation) and psychosocial stressors (i.e. bullying)

  3. Investigations are rarely necessary and should be limited

  4. A fluid intake and voiding diary can be helpful. Calculate the expected bladder capacity and compare to voiding pattern

  5. Most cases can be managed with education and reassurance

  6. Counsel around void practices including scheduled voids and prioritizing fluid intake earlier in the day

  7. Emphasize enuresis is unintentional. Reward children for controllable behaviours (ie. voiding before bed) NOT for ‘dry nights’

  8. For persistent distress, enuresis alarms with moisture sensors can be considered

  9. Short courses of oral desmopressin can be considered for special occasions (ie. Sleepovers/ summer camp)

  10. If additional treatment is desired, consider referral for further investigations and other active treatment options

By understanding the nuances of enuresis and implementing these practical strategies, we can help children and families navigate this common concern with care and compassion, promoting better outcomes for all.


Ref: 1. Canadian Paediatric Society. Position statement. Evaluation and management of enuresis in the general paediatric setting. Posted: August 16, 2023. (accessed September 5, 2023)



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