Which statement about managing primary nocturnal enuresis is true?

The statement about managing primary nocturnal enuresis that is true is that a reward system can help. Implementing a reward system is an effective behavioral approach that reinforces positive behavior in children. When used for enuresis management, this strategy encourages children to stay dry at night by providing incentives, such as praise or small rewards, for successful nights without accidents. This positive reinforcement can boost a child's confidence and motivation to achieve nighttime dryness.

In contrast, increasing fluid intake before bed is generally not recommended, as it can exacerbate the problem by increasing urine production. Pelvic exercises are typically not the primary treatment for nocturnal enuresis; rather, they are more commonly associated with urinary incontinence. Moreover, discouraging the use of alarms is counterproductive, as enuresis alarms are often effective tools in training the child to wake up when they need to use the bathroom, promoting awareness of the need to void at night. Thus, the use of a reward system stands out as a proven method in the management of primary nocturnal enuresis.