Clinical Evaluation and Management of Pediatric Enuresis: A Study at BMU

Abstract

Background: Pediatric enuresis affects millions of children worldwide, causing significant psychological distress. However, clinical evaluation and management data from low-resource settings like Bangladesh remain limited. Objective: To evaluate the clinical presentation and management outcomes of pediatric enuresis in children attending a tertiary care hospital in Bangladesh. Methods: This prospective cohort study was conducted at Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January 2020 to December 2025. A total of 357 children aged 5–16 years with enuresis were enrolled using purposive sampling. Standardized clinical evaluation included history, physical examination, urinalysis, and bladder diary. Management followed a stepwise approach comprising behavioral modifications, alarm therapy, and pharmacotherapy (desmopressin or imipramine) as indicated. Data were analyzed using SPSS version 23.0. Results:  Of 357 children (59.4% male, mean age 8.7±2.4 years), 69.5% had monosymptomatic nocturnal enuresis. After six months of stepwise management, complete response (≥90% reduction in wet nights) was achieved in 231 (64.7%) children, partial response in 86 (24.1%), and no response in 40 (11.2%). Children with monosymptomatic enuresis showed significantly higher complete response than those with non-monosymptomatic enuresis (71.8% vs. 48.6%, p=0.001). Adverse effects occurred in 23 (6.4%) children, all mild and transient. Conclusion: A structured stepwise approach to pediatric enuresis yields favorable outcomes in the majority of children. Clinical evaluation and management are feasible in Bangladeshi tertiary care settings. Larger community-based studies are recommended.  

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 13-18