Updated guideline developed for diagnosis, management of childhood nocturnal enuresis

A new, evidence-based guideline has been established for diagnosing and managing childhood nocturnal enuresis, according to research published in the World Journal of Pediatrics on July 10. Led by Qian Shen from Shanghai's Children's Hospital of Fudan University, a team of nine experts developed the consensus using the Delphi method, gathering input from 42 multidisciplinary panelists through iterative voting.

The guideline outlines key recommendations for diagnosis and treatment, emphasizing updated criteria for identifying children aged 5 years and older who experience involuntary voiding at least once per month for three months. Two classifications of enuresis are discussed: monosymptomatic (NE) and nonmonosymptomatic (NM) NE, differentiated based on the presence of daytime lower urinary tract symptoms.

The recommendations encompass comprehensive evaluation and basic management strategies, with a focus on first-line treatments such as desmopressin for nocturnal polyuria and alarm therapy for reduced bladder capacity. The authors stress the importance of maintaining a voiding diary, recording at least two days of daytime symptoms and seven consecutive nights of sleep, to guide individualized treatment plans and subtype identification.

In cases resistant to conventional treatment, the consensus offers strategies for management, along with guidance for handling NMNE and the role of primary care and traditional Chinese medicine. By compiling evidence and expert insights, this guideline aims to standardize care approaches, foster personalized treatment strategies, and enhance outcomes for children affected by nocturnal enuresis.