4.4.1 Nocturnal enuresis (mono-symptomatic)

Therapy is started when the condition becomes distressing and the child becomes motivated to be dry, usually after the age of 5-6 years. Behavioural therapy including motivation, counselling about regular voiding and drinking habits, classical conditioning with an alarm-clock, and appropriate handling of constipation, is the first option. Complete dryness in 70% and considerable improvement in 12% of cases can be achieved by treatment with 10-40 mg DDAVP (Desmopressin) nasal spray over a maximum period of 6 months. However, relapse occurs in almost all cases after discontinuation of the medication. Oxybutynin can be helpful in some cases with wetting at the beginning of the night (uninhibited contractions of the bladder).