I. Definition Nocturmal enuresis (NE) refers to urinary incontinence that occurs during sleep in children over 5 years old. It is a chronic disease that seriously jeopardizes children’s physical and mental health, growth and development. Common causes include genetics, underdevelopment of the urinary system, underdevelopment of the nervous system (such as spina bifida), psychological factors, etc., resulting in dysfunction of the cerebral cortex and subcortical centers or delayed or impaired development of the urinary reflex arc. (1) Genetic factors: both parents are enuresis, the incidence of children 77%; one parent enuresis as a child, the incidence of their children is about 44%. (2) Small bladder capacity: more than 50% of children with small bladder capacity. (3) sleep too deep: enuresis children are sleeping deeply at night, call can not wake up, even if woke up, often also confused, wet the bed do not know. As a result of sleeping too deeply, so that the brain can not accept the urine from the bladder, and thus urinary retention occurs. (4) Psychological factors: darkness, fear, shock, stress and other factors can lead to urinary loss in children. (5) Improper training of urination habits: the child uses diapers for too long, so that the child cannot develop the habit of controlling urination by himself. Second, classification (1) according to the symptoms: 1. monosymptomatic (MNE) refers to the child in addition to nocturnal enuresis, there is no history of any lower urinary tract symptoms and bladder dysfunction; 2. non-monosymptomatic enuresis (NMNE) refers to the child in addition to nocturnal enuresis is accompanied by lower urinary tract symptoms (LTU). (2) According to the history: 1. Primary (PNE): NE children from the end of continuous cessation of nocturnal bedwetting for more than 6 months, no obvious related diseases, such as neurological disorders, etc.; 2. Secondary (SNE): Continuous cessation of nocturnal bedwetting for more than 6 months re-occurrence of nocturnal bedwetting. III. Diagnosis (1) Ask for medical history: positive family history: coexistence of multiple modes of inheritance: the presence of constipation, fecal incontinence and constipation exists for the presence of spinal cord abnormalities leading to signs of neurogenic bladder; obvious deep sleep; difficult to wake up or wake up delirium; nocturnal polyuria; developmental delays; clumsiness of movement; sensory abnormalities; late speech; daytime urinary incontinence, urinary urgency, and urinary waiting. (2) Physical examination: check the sensation of perineal area, the presence or absence of deformity, spinal extremity examination. (3) Laboratory examination: urine routine + urine bacterial culture to exclude urinary tract infection. (4) Lumbosacral spine plain film: focus on identifying the presence of invisible spina bifida. (5) Urodynamic examination: free urine flow rate, bladder pressure and volume measurement. (6) Intravenous pyelogram: focus on identifying ectopic opening of ureter. IV. Treatment (1) Bladder training: once a day, let the child exercise holding urine for as long as possible. It can expand the bladder capacity and exercise the constraint of urethral sphincter. (2) Alarm bell therapy or timed night urinary loss occurs before waking up to urinate, to promote the establishment of normal urinary reflex. To urinate with the patient fully awake. If the child with enuresis is able to wake up after the alarm bell and get up to urinate more cooperatively, it will be rewarded. (3) Pharmacotherapy: 1. Use of central nervous system excitatory drugs, such as the combined use of chloroquine wake up or the combined application of parasympathetic blockade and sympathomimetic drugs, such as 654-2 and ephedrine; larger children cholinergic receptor blockers (tolterodine 15mg/d); 2. Drugs affecting urinary output, such as antidiuretic hormone desmopressin or miacin, etc. (desmopressin DDAVP200-400ug/ night, po or 20-40ug/night, nasal spray); 3. Meclofenoxate hydrochloride (0.1g, fid) also called chloroform, legerdemain, etc. 4. Other similar drugs such as cerebrolysin. (4)Chinese medicine or acupuncture treatment. (5) If treatment remains unsuccessful for 1 year, intravesical obstruction or neurogenic bladder is considered. Urodynamic and urologic imaging is required.