Evaluation and treatment of nonmonosymptomatic enuresis.

On the basis of some research evidence and consensus, up to one-third of patients with enuresis will have daytime urinary symptoms indicative of lower urinary tract (LUT) dysfunction. (8)(9) On the basis of international consensus, children with enuresis and LUT dysfunction are correctly identified as having nonmonosymptomatic enuresis (NMSE) (formerly termed diurnal enuresis). (1)(2) On the basis of some research evidence and consensus, an adequate voiding and elimination history is the primary tool in differentiating between MSE and NMSE. (2)(7)(8). On the basis of some research evidence and consensus, therapy for NMSE is based on addressing underlying LUT dysfunction, constipation, and comorbid behavioral conditions before addressing enuresis. (2)(8)(9)(12) On the basis of some research evidence and consensus, treatment of underlying BBD and comorbid conditions will often result in improvement or resolution of enuresis. (2)(8)(9)(12). On the basis of international consensus, if enuresis is still present and a concern after treatment of underlying LUT, specific medical or behavioral therapy for enuresis should be offered to the family.(2)(8).