Background: International guidelines advise that stratification of nocturnal enuresis (NE) into non-monosymptomatic (NMNE) and monosymptomatic (MNE) depending on the presence or absence of Lower Urinary Tract Symptoms (LUTS) respectively, is mandatory to optimize therapy. To identify LUTS a checklist (Clinical Management Tool (CMT)) and/or voiding diaries (home recordings) can be used. However, these recordings can be difficult for the family. Moreover, the added value of them, especially in treatment-naïve patients, is rather expert-opinion than evidence-based. Aim: document in treatment-naïve NE patients >5 years: 1) The prevalence of MNE vs NMNE 2) the added value and correlation of CMT and/or diary in differentiating NE. Design: visit 1: CMT was obtained, after a thorough history and basic assessments. If daytime incontinence (DI) and/or LUTS were identified, diagnosis was NMNE. Afterwards, a 2day voiding diary was registered at home. Visit 2: diary was evaluated; if LUTS or abnormal voiding frequency were present, diagnosis was NMNE. Results: 109 children included in 7 Belgian Hospitals (19 lost in follow-up); Mean age 7,7 (±2)years; 62 boys (68,9%), 27 girls (30%). Based on the CMT 13 children diagnosed as MNE (16,7%) and 75 as NMNE (83,3%). Based on the diary 16 children diagnosed as MNE (17,8%) and 74 as NMNE (82,2%). 25 children (27,8%) had the same diagnosis with both methods. Regarding the presence of LUTS we observed significant inconsistencies between the two modalities. There was fair agreement for urge (κ=0,219), moderate agreement for daytime incontinence (κ=0,432) and no agreement for abnormal voiding frequency (κ=-0,057). Conclusion: NMNE is more frequent than MNE in treatment-naïve patients. CMT alone versus CMT+diary had a different sensitivity and specificity of identifying LUTS : in absence of validation by a therapeutic trial, we state that we can only consider patients as MNE when both CMT and diary do not demonstrate LUTS.