Bedwetting Treatment
⚠ Important Note:
This content is based on clinical guidelines (AUA/EAU) for educational use. It does not replace a professional medical consultation. Please consult a specialized doctor before starting any treatment mentioned.
This content is based on clinical guidelines (AUA/EAU) for educational use. It does not replace a professional medical consultation. Please consult a specialized doctor before starting any treatment mentioned.
Bedwetting is the involuntary passing of urine during sleep in children. Bedwetting is a common problem in young children, but it is not a disease.
What is bedwetting treatment?
Bedwetting occurs completely involuntarily and does not happen on purpose. So, do not scold, punish, yell at, or hit the child. Instead of assigning blame, reassure the child that the nocturnal enuresis will stop or be cured over time.
Initial treatment for bedwetting involves education, stimulus therapy, changing fluid intake, and voiding habits. If bedwetting does not improve with these procedures, bedwetting stimulants or medications can be tried.
1. Education and motivational therapy
• The child must be well educated about bedwetting.• Bedwetting is not the children's fault, so don't be angry or blame them.
• Be careful not to harass the child for bedwetting.
• It is important to reduce the stress that the child suffers from as a result of bedwetting.
• Use training pants instead of diapers.
• Make the correct arrangement of lights at night to ensure quiet access to the bathroom at night
• Cover the bed with plastic to protect it from damage.
• Place a big towel below the mattress sheet for additional absorbency.
• Encouraging entering the bathroom daily in the morning so that there is no smell of urine.
• Praise and reward your child for a dry night. Even a small gift for a child is an encouragement.
• Constipation should not be neglected, and it should be treated.
• Avoid caffeine (tea and coffee), soft drinks (cola), and chocolate at night.
• Use the toilet at regular intervals throughout the day, usually without interruption.
• Wake the child every night about three hours after he falls asleep to empty his bladder.
• By determining the most likely time for nocturnal enuresis, the time to wake up must be adjusted.
• In this alarm, a sensor is attached to the child's underwear. When the child empties the bladder in bed, the sensor feels the first drops of urine, and the alarm makes a loud sound to wake the child from sleep. Thus, the awakened child can control his urine until he reaches the bathroom.
• The alarm clock helps train the child to wake up at the right time before bed-wetting occurs.
• Throughout the day, children are asked to drink plenty of water and told to stop urinating, despite their desire to do so.
• With practice, the child will be able to urinate longer. This is due to the strengthening of the bladder muscle, which increases its capacity.
Therefore, this medicine is only useful in those children who produce large amounts of urine. Remember, while your child is taking this medicine, not to drink large amounts of fluids at night to avoid water intoxication.
This medication is usually given before bedtime. And to avoid giving this medicine at night if the child, for any reason, takes large amounts of fluids.
Although this drug is very effective and has few side effects, due to its high cost, many parents cannot afford to buy it.
Because of its quick action, this drug is considered highly effective, but due to its frequent side effects, it is used selectively.
• Encouraging entering the bathroom daily in the morning so that there is no smell of urine.
• Praise and reward your child for a dry night. Even a small gift for a child is an encouragement.
• Constipation should not be neglected, and it should be treated.
2. Reducing fluid intake
• Limit the amount of fluid the child drinks for two to three hours before the child goes to sleep.• Avoid caffeine (tea and coffee), soft drinks (cola), and chocolate at night.
3. Advise on bladder-emptying habits
• Encourage double voiding before going to bed. The urine is routinely emptied.• Use the toilet at regular intervals throughout the day, usually without interruption.
• Wake the child every night about three hours after he falls asleep to empty his bladder.
• By determining the most likely time for nocturnal enuresis, the time to wake up must be adjusted.
4. Bedwetting alarm
• A bedwetting alarm is the most effective way to control bedwetting and is generally intended for children over 7 years old.• In this alarm, a sensor is attached to the child's underwear. When the child empties the bladder in bed, the sensor feels the first drops of urine, and the alarm makes a loud sound to wake the child from sleep. Thus, the awakened child can control his urine until he reaches the bathroom.
• The alarm clock helps train the child to wake up at the right time before bed-wetting occurs.
5. Bladder training exercises
• Many children with bedwetting have a small bladder. The goal of bladder training is to increase its capacity.• Throughout the day, children are asked to drink plenty of water and told to stop urinating, despite their desire to do so.
• With practice, the child will be able to urinate longer. This is due to the strengthening of the bladder muscle, which increases its capacity.
6. Medication therapy
Medications are used as a last resort to stop bedwetting and are generally only used in children older than seven years.a. Desmopressin acetate
Desmopressin tablets are available on the market and are prescribed when other methods have not been successful. This medicine reduces the amount of urine that children produce at night.Therefore, this medicine is only useful in those children who produce large amounts of urine. Remember, while your child is taking this medicine, not to drink large amounts of fluids at night to avoid water intoxication.
This medication is usually given before bedtime. And to avoid giving this medicine at night if the child, for any reason, takes large amounts of fluids.
Although this drug is very effective and has few side effects, due to its high cost, many parents cannot afford to buy it.
B. Imipramine:
Imipramine (a tricyclic antidepressant) has a relaxing effect on the bladder and tightens the sphincter, thus increasing the bladder's ability to hold urine. This medication is usually used for about 3-6 months.Because of its quick action, this drug is considered highly effective, but due to its frequent side effects, it is used selectively.
C. Oxybutynin:
Oxybutynin (an antispasmodic drug) is useful in bed-wetting during the day. This medication reduces bladder spasms and increases bladder capacity. Side effects may include dry mouth, flushing of the face, and constipation.When should children with bedwetting go to the doctor?
The family of a child who suffers from bedwetting should immediately contact a doctor if:
• Involuntary urination during the day.
• Children continue bedwetting after seven or eight.
• The child begins to wet the bed after at least six months of a dry period.
• Loss of control over passing stool.
• The child may complain of symptoms such as fever, pain, burning in the urine, frequent urination, unusual thirst, and swelling of the face.
• weak urine flow and difficulty or straining when passing urine
Bedwetting requires consulting a doctor in case of bed-wetting during the day, fever, burning in urine, or difficulties passing urine.
• Involuntary urination during the day.
• Children continue bedwetting after seven or eight.
• The child begins to wet the bed after at least six months of a dry period.
• Loss of control over passing stool.
• The child may complain of symptoms such as fever, pain, burning in the urine, frequent urination, unusual thirst, and swelling of the face.
• weak urine flow and difficulty or straining when passing urine
Bedwetting requires consulting a doctor in case of bed-wetting during the day, fever, burning in urine, or difficulties passing urine.
This article was written and reviewed by Dr. Hassan Ali - Urologist
Medical References :
Content curated according to international clinical guidelines:
- American Urological Association (AUA).
- European Association of Urology (EAU).
- Campbell-Walsh Urology Textbook.
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