Butler R et al. (2006) Exploring the differences between mono- and polysymptomatic nocturnal enuresis. Scand J Urol Nephrol 40: 313–319

Several schemes have been proposed to classify nocturnal enuresis, but not all aid appropriate, effective clinical intervention. It has recently been proposed that this condition should be classified as monosymptomatic or polysymptomatic, depending on whether bladder overactivity is also present. Butler and colleagues, therefore, conducted a large population survey in the UK to identify variables associated with these two forms of nocturnal enuresis in children.

The authors analyzed data from questionnaires completed by parents of children who participated in the Avon Longitudinal Study of Parents and Children. Complete data were available for 7,935 children aged 90–111 months; in this cohort, 135 boys and 59 girls experienced nocturnal enuresis at least twice a week (2.5%, a low prevalence attributed to the strict criteria used). Nocturnal enuresis was classified as either monosymptomatic (n = 133, 68.5%) or polysymptomatic (n = 61, 31.5%)—similar proportions to those in previously published studies. There were similar numbers of boys and girls in each group.

Compared with children with monosymptomatic nocturnal enuresis, children with polysymptomatic nocturnal enuresis were more likely to have additional bladder and bowel problems: they were 11 times more likely to experience daytime wetting, were markedly more likely to fidget and to need reminders to use the toilet during the day, and they had more-severe and more-frequent bedwetting (i.e. multiple night-time wetting and more wet nights per week).

Butler et al. note that their findings confirm the distinction between these two forms of nocturnal enuresis.