Nocturnal Enuresis in Children

Paracascral transcutaneous electrical nerve stimulation (PTENS) is a credible therapeutic option for nocturnal enuresis. The investigators shall investigate whether maintenance PTENS after initial response improves durability of remission compared with observation alone.

Nocturnal enuresis, commonly known as bedwetting, is a frequent condition that affects many children and can have a significant impact on their self-esteem, social life, and family stress. The causes of bedwetting can vary widely, ranging from deep sleep patterns and excess nighttime urine production to underlying medical conditions like constipation, urinary tract infections, or enlarged tonsils and adenoids (which can affect breathing during sleep).The main goal of this descriptive study is to understand the different types and the underlying causes of bedwetting among children attending the pediatric outpatient clinics at Assiut University Children's Hospital. By identifying these specific causes in the local population, healthcare providers can offer better, more targeted treatments and help reduce the stigma surrounding this condition. During a single clinic visit, researchers will collect information through a structured interview with the parents and the child. The study involves a routine physical examination, including checking weight, height, and looking for physical signs of constipation or enlarged tonsils. Participants will also undergo standard tests to help pinpoint any medical causes, such as a urine test (urinalysis and culture), a basic ultrasound of the abdomen and pelvis, and potentially plain X-rays if issues like severe constipation or airway blockages are suspected. The study aims to include at least 80 male and female children aged 5 years and older who have been experiencing bedwetting at least twice a week for three months or more.

The goal of this clinical trial is to compare combination of Solifenacin and MIrabegron in treatment of primary mono-symptomatic nocturnal enuresis in children. It will also learn about the safety of that combination. The main questions it aims to answer are: Does combination of Solifenacin and MIrabegron lower the number of wet nights? What medical problems do participants have when taking combination of Solifenacin and MIrabegron? Researchers will compare the combination to omegapress to see if the combination works better to treat primary mono-symptomatic nocturnal enuresis. Participants will: Take the combination or Omegapress every day for 3 months Visit the clinic once monthly for checkups and tests Keep a diary of their symptoms and the number of wet nights

The aim of this randomized controlled trial is to evaluate the effects of Structured Pelvic Floor Muscle Rehabilitation (SPFMR) in children with Primary Monosymptomatic Nocturnal Enuresis (PMNE) who are undergoing desmopressin asetat (DDAVP) treatment prescribed by a pediatric urologist. The study aims to investigate whether SPFMR can reduce the frequency and severity of enuresis episodes and whether it can also reduce relapse rates in the short- and long-term follow-up. The main questions the study seeks to answer are: * Does SPFMR reduce the frequency and severity of enuresis episodes in children with PMNE? * Does SPFMR treatment reduce relapse rates in children with PMNE in the long term? Researchers will compare the group receiving SPFMR in addition to DDAVP treatment with a control group receiving only DDAVP treatment. This comparison will help evaluate the effect of SPFMR on the severity of enuresis episodes and relapse rates. Participants will: * Receive DDAVP treatment (SPFMR group and Control group) * Participate in SPFMR sessions ( SPFMR group) * Keep a diary of enuresis frequency and severity * Assess relapse during short- and long-term follow-up The hypotheses of the study are: H0: Adding SPFMR to desmopressin treatment for children with PMNE has no short-term effect on the severity of enuresis episodes. H1: Adding SPFMR to desmopressin treatment for children with PMNE has a short-term effect on the severity of enuresis episodes. H0: Adding SPFMR to desmopressin treatment for children with PMNE has no long-term effect on the severity of enuresis episodes. H2: Adding SPFMR to desmopressin treatment for children with PMNE has a long-term effect on the severity of enuresis episodes.

The aim of the study is to evaluate the role of sulbutiamine in treatment of monosymptomatic nocturnal enuresis in children by using it alone or as a combination therapy with tricyclic antidepressants (imipramine+sulbutiamine).