Treatment Overview

Most children gain bladder control over time without any treatment. Bed-wetting that continues past the age that most children have nighttime bladder control—typically at 5 or 6 years of age—also will usually stop over time without treatment. If not, home treatment may be all that is needed to help a child stop wetting the bed. Home treatment may include:

• Monitoring when and how much your child drinks. Give your child most of his or her needed fluids in the morning and afternoon.
• Restricting your child's intake of caffeine, especially at night.
• Having your child use the toilet before going to bed.
• Reminding your child to get up during the night to go to the bathroom.
• Letting the child help solve the problem, if he or she is older than 4.
• Offering your child disposable nighttime training underpants. Don't force a child to wear them, but if you are both comfortable with using them, there is no reason not to.
• Praising and rewarding the child for dry nights.

If home treatment is unsuccessful, if the child and parents need assistance, or if the bed-wetting may be caused by a medical condition, medical treatment may be helpful. The goal of medical treatment is to decrease the frequency of bed-wetting and to increase the child's use of the toilet at night if needed. Eventually bed-wetting will stop completely, but this may not happen immediately after treatment.

• Treatment is considered successful if the child remains dry for 14 nights in a row within 16 weeks of treatment.
• Treatment is considered a complete success if the child does not have any accidental wettings for 2 years after treatment.
• Children who have an increase in accidental wettings after treatment are considered to have relapsed. A relapse is defined as more than 2 wet nights in 2 weeks. The most likely time for a child to relapse is within the first 6 months after treatment. If a child relapses after stopping a successful therapy, that same therapy usually is repeated.

Medical treatment for bed-wetting may include:

• Education for the parents and child about what is normal and expected for children as they grow and about how the urinary system works.
• Motivational therapy. This method involves parents encouraging and reinforcing a child's sense of control over bed-wetting.
• Moisture alarms, which detect wetness in the child's underpants during sleep and sound an alarm to wake the child.
• Desmopressin and tricyclic antidepressant medicines. These medicines, which increase the amount of urine that the bladder can hold or decrease the amount of urine released by the kidneys, may help some children.