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Bed wetting (findings from the history and possible explanation)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • NICE have outlined findings from the history of a child with nocturnal enuresis (bedwetting) and possible interpretation of that history

Findings from history

Possible interpretation

Large volume of urine in the first few hours of night

Typical pattern for bedwetting only

Variable volume of urine, often more than once a night

Typical pattern for children and young people who have bedwetting and daytime symptoms with possible underlying overactive bladder

Bedwetting every night

Severe bedwetting, which is less likely to resolve spontaneously than infrequent bedwetting

Previously dry for more than 6 months

Bedwetting is defined as secondary

  • Daytime frequency
  • Daytime urgency
  • Daytime wetting
  • Abdominal straining or poor urinary stream
  • Pain passing urine

Any of these may indicate the presence of a bladder disorder such as overactive bladder or more rarely (when symptoms are very severe and persistent) an underlying urological disease


A common comorbidity that can cause bedwetting and requires treatment


Frequent soiling is usually secondary to underlying faecal impaction and constipation which may have been unrecognised

inadequate fluid intake

May mask an underlying bladder problem, such as overactive bladder disorder, and may impede the development of an adequate bladder capacity.

Behavioural and emotional problems

These may be a cause or a consequence of bedwetting. Treatment may need to be tailored to the specific requirements of each child or young person and family.

family problems

A difficult or 'stressful' environment may be a trigger for bedwetting. These factors should be addressed alongside the management of bedwetting

practical issues

Easy access to a toilet at night, sharing a bedroom or bed and proximity of parents to provide support are all important issues to consider and address when considering treatment, especially with an alarm.



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