Evaluation and treatment of nonmonosymptomatic nocturnal enuresis: a standardization document from the International Children's Continence Society

J Pediatr Urol. 2013 Apr;9(2):234-43. doi: 10.1016/j.jpurol.2012.10.026. Epub 2012 Dec 21.


Purpose: This document represents the consensus guidelines recommended by the ICCS on how to evaluate and treat children with nonmonosymptomatic nocturnal enuresis (NMNE). The document is intended to be clinically useful in primary, secondary and tertiary care.

Materials and methods: Discussions were held by the board of the ICCS and a committee was appointed to draft this document. The document was then made available to the members of the society on the web site. The comments were vetted and amendments were made as necessary to the document.

Results: The main scope of the document is the treatment of NMNE with drugs other than desmopressin-based therapy. Guidelines on the assessment, and nonpharmacologic and pharmacologic management of children with NMNE are presented.

Conclusions: The text should be regarded as an expert statement, not a formal systematic review of evidence-based medicine. It so happens that the evidence behind much of what we do in the care of enuretic children is quite weak. We do, however, intend to present what evidence there is, and to give preference to this rather than to experience-based medicine, whenever possible.

Publication types

  • Consensus Development Conference
  • Systematic Review

MeSH terms

  • Antidiuretic Agents / therapeutic use
  • Botulinum Toxins, Type A / therapeutic use*
  • Child
  • Deamino Arginine Vasopressin / therapeutic use
  • Diurnal Enuresis / diagnosis*
  • Diurnal Enuresis / drug therapy*
  • Electric Stimulation Therapy*
  • Humans
  • Neuromuscular Agents / therapeutic use
  • Nocturnal Enuresis / diagnosis*
  • Nocturnal Enuresis / drug therapy*
  • Practice Guidelines as Topic


  • Antidiuretic Agents
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
  • Deamino Arginine Vasopressin