What is the appropriate management for a 4-year-old boy with primary nocturnal enuresis and no daytime symptoms?

In the case of a 4-year-old boy with primary nocturnal enuresis who does not exhibit any daytime symptoms, initial reassurance is considered the most appropriate management. Primary nocturnal enuresis is a common condition in young children, and for many, it is a developmental issue that resolves on its own over time.

At this age, it is important to provide reassurance to the parents that this condition is not uncommon and can be a normal part of childhood development. Most children will outgrow enuresis without any significant intervention, especially when there are no accompanying daytime symptoms indicating a more serious underlying problem.

Management options such as enuresis alarms, medications like Desmopressin, or referral to a specialist clinic may be considered in older children or those who exhibit more complex cases or failure to respond to initial reassurance over time. However, for a child as young as four years with no complicating factors, support and reassurance offer a positive approach while monitoring for natural improvement.