Bedwetting Treatments

Treatment

Treatment for aims to gradually reduce the frequency of bed-wetting until the child essentially grows out of it. Treatment is rarely appropriate before age six, which is usually when bed-wetting begins to interfere with social development.

Motivation and Family Support

Bed-wetting is rarely an intentional act. Children are usually upset and ashamed when it happens. Do not punish the child. It is very important that parents offer encouragement that the bed-wetting will stop with time. Do not let siblings tease the child who wets the bed. Keep careful records of the child's progress and offer consistent support. A very simple motivational method is the use of positive feedback, such as a star chart.

Fluids should be restricted after 6:00-7:00 in the evening, and the child should void before going to bed. Sugar and caffeine should also be avoided after late afternoon.

Behavioral Conditioning

The doctor may recommend a conditioning device, such as a pad with a buzzer that sounds when wet. The child wears the pad in his underwear. The alarm wakes the child to get up and use the toilet. Parents may need to help the child get to the bathroom and reset the alarm.

Most studies suggest that this form of treatment has the highest success rate and the fewest complications. Adding another type of therapy, like dry bed training, can also help your child succeed. Dry bed training involves following a schedule where you awaken your child during the night so he can use the bathroom. *²

Bladder Training

Some doctors suggest bladder-stretching exercises, but there is little evidence that this approach works. While awake, the child gradually increases the amount of time that elapses between urinations. Do not try this method without talking to the doctor.

Medication

Drugs to treat symptoms include:

Desmopressin (DDAVP Nasal Spray, DDAVP Rhinal Tube, DDAVP, DDVP, Minirin, Stimate Nasal Spray)—a hormone available as a nasal spray or in tablet form used to decrease the amount of urine produced
- According to the Food and Drug Administration, children and adults taking the nasal form of desmopressin are at risk for developing severe hyponatremia. This condition occurs when there are low levels of sodium in the blood, which can result in seizures and death. If you have hyponatremia or a history of it, do not take the nasal spray. Also, if you have an illness that may lead to fluid and/or electrolyte imbalance, do not take the tablet form. Desmopressin should be used with caution if you are at high risk for water intoxication with hyponatremia. *¹
Imipramine (Tofranil-PM, Tofranil)—an antidepressant that lightens the level of sleep and may also decrease the frequency of urination
Oxybutynin (Ditropan XL, Ditropan, Oxytrol)—an anticholinergic agent that has been used, but has a low response rate