A new consensus guideline published in the World Journal of Pediatrics aims to bring consistency and personalization to the diagnosis and management of childhood nocturnal enuresis (NE)—commonly known as bedwetting. Developed by a nine-member writing group led by researchers at the Children's Hospital of Fudan University in Shanghai, the guideline used the Delphi method, with 42 multidisciplinary panelists voting iteratively to reach consensus on 18 key recommendations.

The updated diagnostic criteria now include children aged 5 and older who experience at least one involuntary void per month over three months. A key emphasis is placed on classifying NE as either monosymptomatic or nonmonosymptomatic (NMNE) based on daytime lower urinary tract symptoms, which helps guide treatment decisions. Clinicians are also advised to have families maintain a voiding diary—at least two days of daytime records and seven consecutive nights—to determine enuresis subtype.

Key Takeaways:

• First-line treatments: desmopressin for nocturnal polyuria; alarm therapy for reduced bladder capacity
• Voiding diaries are essential for subtype classification and treatment planning
• Guidelines also address treatment-resistant cases, NMNE management, and the role of primary care and traditional Chinese medicine

Why it matters: Bedwetting affects millions of children worldwide and can significantly impact quality of life. Standardized, evidence-based guidelines help ensure children receive timely, appropriate, and individualized care.