Historically, child bedwetting was seen primarily as a psychiatric disorder. This view has changed since the functional disturbances of the organs involved and neurobiological connections have been investigated. Enuresis is not seen today as a single “disease,” but as a complex symptom, which can be attributed to many organic causes.

Our bibliography is designed to provide parents with information into the causes and treatment of enuresis. Bedwetting children need special attention and support from their family. Reproaches due to blame are completely out of place. A child is not responsible for his/her genes and his maturation processes. It is equally important that the child is offered appropriate and effective treatment. Effective, in our understanding means proven effectiveness. Unfortunately, the Internet offers many therapies and suggestions without proof of efficacy or they are even proven ineffective.

For non-physicians, the change in the technical terms that has taken place in recent years can be confusing. The current terminology has been developed by ICCS (2006) [1] and ICI (2008) [2]. The disease now designated as “monosymptomatic enuresis” corresponds to the former “enuresis.” The “non-monosymptomatic enuresis” partially coincides with the earlier concept of “childlike urge incontinence.”


Monosymptomatic enuresis
  • Bedwetting during sleep as the only symptom on at least 2 nights per month after having reached 5 years of age
  • There are no symptoms during day or a bladder malfunction
Non-monosymptomatic enuresis
  • Nocturnal incontinence with simultaneous symptoms of bladder dysfunction, e.g. overactive, small-capacity bladder
  • No incontinence during the day
Childhood incontinence
  • Bedwetting during sleep and additionally involuntary urine losses during the day
Primary enuresis
  • Enuresis from birth without reaching a dry interval of six months
Secondary enuresis
  • Recurrence of enuresis after a dry period of at least six months


  1. Nevéus T, von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children‘s Continence Society. J Urol 2006; 176:314–24.
  2. Abrams P, Cardozo L, Khoury S, et al. (eds). Incontinence. 4th International Consultation on Incontinence, Paris July 5–8, 2008. Editions21, Paris, 2009.


  1. AWMF Guideline: Enuresis and non-organic (functional) urinary incontinence in children and adolescents Registration number 028 – 026 Classification S2k Status: 12/02/2015, valid until 12/01/2020
  3. Abrams P, Cardozo L, Khoury S, et al. (eds). Incontinence. 4th International Consultation on Incontinence, Paris July 5–8, 2008. Editions21, Paris, 2009.
  4. Glazener CMA, Evans JHC, Peto RE. Alarm interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD002911.
  5. Nevéus, Tryggve. “Nocturnal enuresis—theoretic background and practical guidelines.” Pediatric Nephrology 26.8 (2011): 1207-1214.
  6. Vande Walle, Johan, et al. “Practical consensus guidelines for the management of enuresis.” European journal of pediatrics 171.6 (2012): 971-983.
  7. Teles A, Lordêlo P (2016) Alarm for the Treatment of Enuresis: Review of Treatment Types and Treatment Efficacy. J Sleep Med Disord 3(6): 1066.
  8. Kamperis K, Hagstroem S, Rittig S, Djurhuus JC. Combination of the enuresis alarm and desmopressin: second line treatment for nocturnal enuresis. J Urol 2008; 179: 1128-1131 [PMID: 18206924 DOI: 10.1016/j.juro.2007.10.088]
  9. Robertson, Beau, Keong Yap, and Sharynn Schuster. “Effectiveness of an alarm intervention with overlearning for primary nocturnal enuresis.” Journal of pediatric urology 10.2 (2014): 241-245.
  10. Claudius, Gourav, Jugesh Chhatwal, and Inderpreet Sohi. “Efficacy of alarm intervention in primary monosymptomatic nocturnal enuresis in children.” International Journal of Contemporary Pediatrics 3.2 (2016): 621-624.
  11. Ahmed, Abul-Fotouh Abdel-Maguid, et al. “Efficacy of an enuresis alarm, desmopressin, and combination therapy in the treatment of saudi children with primary monosymptomatic nocturnal enuresis.” Korean journal of urology 54.11 (2013): 783-790.
  12. Cederblad, Maria, et al. “No effect of basic bladder advice in enuresis: A randomized controlled trial.” Journal of pediatric urology 11.3 (2015): 153-e1.
  13. 15. Sinha R, Raut S. Management of nocturnal enuresis – myths and facts. World J Nephrol 2016; 5(4): 328-338 Available from: URL:


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  2. Spee-van der Wekke J, Hirasing RA, Meulmeester JF, Radder JJ. Childhood nocturnal enuresis in The Netherlands. Urology 1998; 51: 1022-1026 [PMID: 9609644 DOI: 10.1016/S0090-4295(98)00106-X]
  3. Yeung CK, Sreedhar B, Sihoe JD, Sit FK, Lau J. Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study. BJU Int 2006; 97: 1069-1073 [PMID: 16643494 DOI: 10.1111/j.1464-410X.2006.06074.x]
  4. Feehan M, McGee R, Stanton W, Silva PA. A 6 year follow-up of childhood enuresis: prevalence in adolescence and consequences for mental health. J Paediatr Child Health 1990; 26: 75-79 [PMID: 2361070 DOI: 10.1111/j.1440-1754.1990.tb02390.x]
  5. Yeung CK, Sihoe JD, Sit FK, Bower W, Sreedhar B, Lau J. Characteristics of primary nocturnal enuresis in adults: an epidemiological study. BJU Int 2004; 93: 341-345 [PMID: 14764133 DOI: 10.1111/j.1464-410X.2003.04612.x]
  6. Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR. Prevalence of enuresis and its association with attention deficit/ hyperactivity disorder among U.S. children: results from a nationally representative study. J Am Acad Child AdolescPsychiatry 2009; 48: 35-41 [PMID: 19096296 DOI: 10.1097/CHI.0b013e318190045c]
  7. Sureshkumar P, Jones M, Caldwell PH, Craig JC. Risk factors for nocturnal enuresis in school-age children. J Urol 2009; 182: 2893-2899 [PMID: 19846154 DOI: 10.1016/j.juro.2009.08.060]


  1. von Gontard A, Heron J, Joinson C. Family history of nocturnal enuresis and urinary incontinence: results from a large epidemiological study. J Urol 2011; 185: 2303–6.
  2. Eiberg H, Berendt I, Mohr J. Assignment of dominant inherited nocturnal enuresis (ENUR1) to chromosome 13q. Nat Genet 1995;10: 354-356 [PMID: 7670476 DOI: 10.1038/ng0795-354]
  3. Arnell H, Hjälmås K, Jägervall M, Läckgren G, Stenberg A,Bengtsson B, Wassén C, Emahazion T, Annerén G, Pettersson U, Sundvall M, Dahl N. The genetics of primary nocturnal enuresis: inheritance and suggestion of a second major gene on chromosome 12q. J Med Genet 1997; 34: 360-365 [PMID: 9152831 DOI:10.1136/jmg.34.5.360]
  4. Watanabe H. : Sleep patterns in children with nocturnal enuresis. Scand J Urol Nephrol, Suppl. 173, 55 – 57, 1995
  5. Wolfish N. M. et al. : Elevated sleep arousal thresholds in enuretic boys: clinical implications. Acta Paediatrica 86, 381 – 384, 1997
  6. Yeung CK, Diao M, Sreedhar B. Cortical arousal in children with severe enuresis. N Engl J Med 2008; 358: 2414-2415 [PMID:18509134 DOI: 10.1056/NEJMc0706528]
  7. Cohen-Zrubavel V, Kushnir B, Kushnir J, Sadeh A. Sleep and sleepiness in children with nocturnal enuresis. Sleep 2011; 34: 191-194 [PMID: 21286252]
  8. von Gontard A, Freitag CM, Seifen S, Pukrop R, Röhling D. Neuromotor development in nocturnal enuresis. Dev Med Child Neurol 2006; 48: 744-750 [PMID: 16904021 DOI: 10.1017/S0012162206001599]
  9. Kayama Y, Koyama Y. Brainstem neural mechanisms of sleep and wakefulness. Eur Urol 1998; 33 Suppl 3: 12-15 [PMID: 9599730 DOI: 10.1159/000052235]
  10. Schulz-Juergensen, S, et al. “Effect of alarm therapy on conditioning of central reflex control in nocturnal enuresis: pilot study on changes in prepulse inhibition (PPI).” Pediatric Nephrology 29.7 (2014): 1209-1213.
  11. Nevéus, Tryggve. “Pathogenesis of enuresis: Towards a new understanding.” International Journal of Urology (2017).
  12. Nevéus, Tryggve, et al. “Respiration during sleep in children with therapy‐resistant enuresis.” Acta Paediatrica 103.3 (2014): 300-304.
  13. Rittig S, Schaumburg HL, Siggaard C, et al. The circadian defect in plasma vasopressin and urine output is related to desmopressin response and enuresis status in children with nocturnal enuresis. J Urol 2008; 179: 2389–95.
  14. Kamperis K, Rittig S, Jørgensen KA, Djurhuus JC. Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment. Am J Physiol Renal Physiol 2006; 291: F1232-F1240 [PMID: 16804103 DOI: 10.1152/ajprenal.00134.2006]
  15. Redsell, S. A., and Jacqueline Collier. “Bedwetting, behaviour and self‐esteem: a review of the literature.” Child: care, health and development 27.2 (2001): 149-162.


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  6. Tobias, Nan E., and Gail C. McCain. “A comparison of two enuresis alarms.” Urologic nursing 21.5 (2001): 349.
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  10. Briedis, Ugis, Aleksandrs Valisevskis, and Marianna Grecka. “Development of a Smart Garment Prototype with Enuresis Alarm Using an Embroidery-machine-based Technique for the Integration of Electronic Components.” Procedia Computer Science 104 (2017): 369-374.
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