When should enuresis be referred for further evaluation?

Referral for further evaluation of enuresis is generally recommended when the condition persists beyond age 5 and occurs more than once a month for a duration of three months. This guideline is based on the understanding that while enuresis can be a common occurrence in younger children, it often resolves on its own. However, if a child over the age of 5 is experiencing frequent episodes, it may indicate an underlying issue that warrants professional assessment.

Persistent nighttime urination in children can potentially be linked to physiological or psychological factors, such as developmental delays, urinary tract infections, or emotional stress. Thus, a more comprehensive evaluation can help identify the root cause and determine appropriate interventions or treatments.

Other scenarios presented, such as recurrence more than once a week or merely occurring at night, do not by themselves necessitate referral unless they are coupled with additional concerning factors or persist past a certain developmental age. Similarly, enuresis in children before age 3 is often considered within the normal range of development since many children have not yet achieved nighttime continence by that age.