How is bedwetting treated?

If there is no medical cause for bedwetting, your doctor can provide tips on managing the condition. Bedwetting can be treated by changing the child’s behavior or with various oral (taken by mouth) medications.

Behavioral techniques include:

  • Limiting fluids before bedtime: Don’t give your child anything to drink at least two hours before bedtime. Make sure your child drinks plenty of fluids during the day.
  • Going to the bathroom before bedtime: Make sure your child goes to the bathroom and empties his or her bladder completely before going to bed.
  • Enuresis alarm: This is an electrical device that makes a loud noise or vibrates to awaken the child when he or she starts to wet the bed. It has a wetness sensor that sets off the alarm so that the child can wake up and finish urinating in the bathroom. Over time, the child learns to wake up when he or she feels the sensation of a full bladder, and eventually might be able to sleep through the night without having to urinate. This technique may take several months to produce results.
  • Nighttime waking: Parents sometimes find it helpful to awaken their child a few hours after bedtime and take him or her to the bathroom. One problem with this method is that it trains the child to awaken at a certain time each night, without teaching him or her to recognize the internal signals associated with a full bladder.
  • Bladder therapy: This approach is aimed at gradually increasing the bladder’s functional capacity by making the child wait to go to the bathroom. Increasing the length of time between bathroom visits helps enlarge the bladder to allow it to hold more urine.
  • Counseling: Psychological counseling may be effective in cases where the child has had a traumatic event or is suffering from low self-esteem because of the bedwetting.

Medications

The following medications may be used alone or in combination with behavioral techniques to treat bedwetting:

  • Desmopressin: This is the man-made version of the hormone vasopressin, which causes the kidneys to produce less urine. It is effective in about half of all cases, with better results in older children who have normal bladder capacity. The drug can lower sodium levels in children who take it, so parents should limit the amount of fluids their child drinks after dinner. This is the most common medication prescribed to help control bedwetting.
  • Oxybutinin: This medication is used to treat overactive bladder by reducing bladder contractions. It is generally used along with desmopressin or the enuresis alarm method. It may be effective for children who wet the bed more than once each night and who also have daytime wetting.
  • Imipramine: This drug is effective in 40% of cases, but it must be used with caution because of the risk of serious side effects.

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