Bed-wetting in children: what your doctor can do

Are any tests needed? If your child seems healthy apart from the bed-wetting, it is very unlikely that there is a serious cause. The only necessary test is a urine check. Your doctor will send a sample to the laboratory to check for infection, and will also do a simple dipstick test to make sure the urine is not abnormal in any other way.

Bed-wetting alarms (enuresis alarms) are suitable for children older than 7 years. They ring or buzz when your child begins to wet the bed. These are the most effective treatment. They wake the child, and this gets him or her into the habit of waking up when urine needs to be passed. There are two main types of alarm. In the UK, you can buy them from ERIC (see useful contacts), or your doctor or practice nurse can arrange for you to borrow one. Even if you decide to buy one, it is important that the practice nurse shows you how to use it properly. Using an alarm requires lots of patience and commitment, but is worthwhile. There are two main types of alarm.

Pad and bell alarms have a plastic mat that you put into the middle of the bed, where wetness usually occurs. The mat has an electrical circuit within it that is connected by a flex to a bell or buzzer alarm. You place the alarm out of reach so that your child has to get out of bed to switch it off, and then go to the toilet.
Mini-alarms are neater. They clip onto the child's nightwear, near the collar. A thin flex connects the alarm to the sensor, which you attach to the underpants or knickers. Wetness activates the alarm. It can be switched off temporarily, but the child has to change into dry clothes to prevent it going off again.

Using a bed-wetting alarm

For at least the first 10 nights, you will probably have to wake your child when you hear the alarm, so that he or she can switch it off and go to the lavatory. You will need to help your child change the sheets and reset the alarm. A ‘baby alarm’ system will help you to hear the bed-wetting alarm when it goes off.
After about 10 days, many children will have learned to wake up promptly to ‘beat the buzzer’, so there will be a smaller wet patch. This is progress, so tell your child how pleased you are.
If your child does not wake with the alarm, make it louder by placing the sound box in a tin.
Be patient. Some children become dry after about 2 months of using the alarm, but many need 4 months.
If your child becomes completely dry using the alarm, carry on using it for a further month.
Bed-wetting alarms do not work for all children. The success rate is about 70%. If after about 6 weeks, there is no progress at all (such as a smaller wet patch, or the alarm going off later in the night), it is best to stop using it, and try again after a few months.
Although about 70% of children become dry while using the alarm, some start bed-wetting again when they stop using it. A study found that 45% of children who had alarms remained dry afterwards (Drug and Therapeutics Bulletin 2004;42:33–7).

Medicines for bed-wetting can be very helpful, but they do not really cure the problem. When the child stops taking them, bed-wetting often occurs again. But they are a useful stopgap, for example, to use during a school trip. You require a doctor's prescription for these medicines.Desmopressin helps the kidneys make less urine. It can be taken as tablets or as a nose spray. On average, taking desmopressin gives 2 dry nights a week, and about one-third of children will be completely dry.

Desmopressin helps the kidneys make less urine. It can be taken as tablets or as a nose spray. On average, taking desmopressin gives 2 dry nights a week, and about one-third of children will be completely dry.
Oxybutynin and tolterodine are medications that calm overactive bladder muscle. Either may be helpful if your child has daytime wetting as well as bed-wetting, and has to rush to get to the toilet (urgency). They can cause side effects (dry mouth, constipation, blurred vision), but these are minimized by taking the medication at night.
Imipramine is a medication that somehow helps the bladder hold more urine. On average, taking imipramine gives 1–2 dry nights a week. It used to be popular, but is not used much now. It has some side effects and is very dangerous if too much is taken. It is not as effective as desmopressin.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 26th 2010

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Comments on this article

Posted by Gaynor on 14/07/2010 at 05:22:15 am

My son will be 7 in September, I have been trying to get dry at night for about 18 months, I have tried lifting him, but still had a wet bed in the morning. I now have a wet bed every night, I am getting tired as I work full time and having to get up and change beds and bath him. Do wearing the payjama pants help? We are going on holiday and can't think of anything else, but I am worried incase they give him to much security

Posted by Anita on 26/02/2009 at 06:40:00 pm

My son will be 7 in April, and wets the bed every night still. He wears pyjama pants,which I did without last summer incase they give too much security, but after 6 weeks of changing sheets everynight, I became shattered so back went on the pyjamam pants.He also has to visit the toilet many times in the day. I'm worried he wont ever grow out of this.

Posted by Anonymous on 23/02/2009 at 12:25:00 pm

My son wets the bed once or twice a week. Sometimes he can go longer periods not wetting.Even when we wake him during the night to go and urinate a second time, he can still wet the bed before morning. Also the odd occasion during the day.Idont know what to do ?(daytime once in a month which i have felt is laziness).When asked he says he does not feel it.

Posted by lsverick on 03/02/2009 at 05:08:00 pm

my son has been bed wetting and never dry for any number of nights. we have tried praise when dry, lifting out, encouraging drinks through day, holding urine and nothing improved, he was becoming very tired through broken sleep. We were given help through our doctor and tried an alarm which worked for a while then he slept through it. We are now trying tablets which have improved things slightly. My son has a problem with sugar and uses his up very quickly and has to snack often or becomes very tired and irratable I sometimes think there may be a link, he is also a very deep sleeper.

Posted by 2YK on 21/01/2009 at 05:10:00 am

Experience the first time, enuresis. This really shocked me, cos the day before I was on dry fasting, ie no liquid and food consume at all. Normally, when i am on dry fast, i dont have no urine to let go, so, why i had this problem. what could be the cause of it