Nocturnal Enuresis
Nocturnal enuresis is repeated bedwetting during sleep in a child or adult beyond the expected age of night-time bladder control.
Key points
- Primary enuresis has never resolved, while new wetting after at least six dry months may reveal a new medical or emotional factor.
- Constipation, daytime urinary symptoms, snoring, excess thirst and weak stream should be assessed before night-only treatment.
- Alarm therapy offers durable improvement; desmopressin gives temporary control and requires strict evening fluid limits.
The listings below are not suitable without clarifying the pattern; sodium, kidney, heart and fluid-balance risks matter.
Assessment without blame
A bladder and fluid diary helps identify small capacity or excess night urine. Urine testing is used when symptoms are new or include pain, frequency or thirst. Bedwetting is not deliberate, and punishment worsens distress without helping continence.
Treatment choices
Treat constipation and daytime bladder dysfunction first. A moisture alarm needs consistent family support over weeks. Desmopressin may suit short-term control or nocturnal polyuria, but excess drinking can cause low sodium; follow sick-day instructions when vomiting or diarrhoea occurs.
When to seek urgent care
Seek prompt assessment for fever, back pain, painful urination, marked thirst, weight loss or new neurological symptoms. Headache, vomiting, confusion or seizure after desmopressin is an emergency.


