TENS in Nocturnal Enuresis

Inclusion Criteria: * Diagnosis of primary monosymptomatic nocturnal enuresis (PMNE) based on International Children's Continence Society (ICCS) criteria. * Persistent symptoms after at least 8 weeks of standardized urotherapy, including counseling on timed voiding, evening fluid management, and bowel optimization. * Baseline severity of ≥3 wet nights per week on a 14-night diary. * Ability of the child and caregiver to complete diaries and comply with home treatment and follow-up. Exclusion Criteria: * Non-monosymptomatic enuresis, daytime urgency, daytime incontinence, dysfunctional voiding, or significant post-void residual. * Neurogenic bladder, spinal dysraphism, cerebral palsy, epilepsy uncontrolled on treatment, or other neurologic diseases affecting lower urinary tract function. * Congenital or acquired urinary tract abnormalities. * Active urinary tract infection. * Untreated or refractory constipation at enrollment. * Implanted electrical devices, significant dermatologic lesions at electrode sites, or other contraindications to electrical stimulation. * Cognitive, behavioral, or social circumstances preventing adherence.