Complementary, holistic, and integrative medicine: nocturnal enuresis.

device. Introduction Nocturnal enuresis (NE) is characterized by the involuntary discharge of urine at night in those 5 years of age or older. Primary NE (PNE) is diagnosed in an individual who has never achieved nighttime dryness; in secondary NE (SNE), incontinence follows a dry period of at least 6 months. In either, the enuresis must not be due exclusively to a medical condition or diuretic therapy. Prevalence is estimated at 5% to 10% among 5-year-olds, 3% to 5% among 10-year-olds, and 1% among those 15 years of age and older. Between 5% and 10% of cases resolve annually without treatment. (1) The causes of PNE and SNE remain unclear, although physical, neurologic, and psychological factors; genetics; sleep structure; and other medical conditions have been implicated. (2) Treatment for NE includes pharmacologic and nonpharmacologic options, and many families are interested in complementary and integrative approaches. This review assesses the efficacy and safety of acupuncture/acupressure, hypnosis, and biofeedback in treating NE.