Bedwetting is a condition in which an individual accidentally passes urine at night during sleep. It is extremely common among children but can last into the teen years. Bedwetting is often a natural part of the development and most young kids gain bladder control over time without any treatment. Nocturnal enuresis that continues past the age that most kids have bladder control will need treatment. There are numerous bedwetting treatment options that have been extensively studied over many years and which have been found to be very effective and well-tolerated.
A number of self-help techniques are available which may help prevent or at least reduce frequent episodes of bed-wetting. This bed-wetting treatment option includes reminding your child to urinate before going to bed and encouraging him or her to limit liquid intake in the last two hours before bedtime. These techniques can help your child to achieve dry nights. Using cloth underwear and reusable waterproof bedding helps prevent a child from the guilt and shame of wetting the bed.
Motivational therapy involving encouragement and praise for dry nights can have profound positive effects on the self-esteem and self-image of a child. This bed-wetting treatment option includes reward schemes such as token
and reward system; which have been shown to be very helpful in managing bed-wetting. In this scheme, a colorful chart is used to keep track of a child's progress with a gold star for every dry night. At the end of the month, you can present your child with a reward based on his or her performance.
Behavioural Therapy is among the most effective of all bed-wetting treatments for nocturnal enuresis The aim of behavioral therapy is to teach a bed-wetting sufferer to recognize and respond to a full bladder during sleep. A
bed-wetting alarm (enuresis alarm) can be used to teach a child to wake up whenever he or she starts wetting the bed and go to the toilet to empty the urinary bladder. There are two types of alarm: body-worn alarms that can be
clipped onto the child's underpants, and pad and bell alarms which have a pad connected to a bell or alarm that starts ringing when the pad detects moisture. Generally, behavioural therapy bed-wetting treatment options should
be combined with motivational therapy before trying medication therapy.
No medication cures bed-wetting. They only treat the symptoms. Once the medication is stopped, bed-wetting returns. Bed-wetting medications are available by prescription and parents should consult with a physician on the side effects of this bed-wetting treatment option.
- Desmopressin acetate (DDAVP) which is a synthetic hormone has been shown to be effective in reducing the overnight production of urine. The drug can be taken as a tablet or nasal spray. Desmopressin should be given at bedtime and a child should not be allowed to drink too much fluid before going to bed.
- Imipramine is another medication that has been used successfully for many years to treat bedwetting children. This drug is thought to work by relaxing the muscles of the bladder, thus increasing its capacity and reducing the urge to urinate. Success rates with imipramine have been found to be higher in children older than 7 years of age.
- Anticholinergics drugs such as hyosyamine and oxybutynin help reduce bladder contractions, affecting the time a child can hold urine in the bladder. It is used in combination with desmopressin for treating bed-wetting in children with reduced functional bladder capacity. The reason behind this approach is that the oxybutynin increases nighttime bladder volume and the desmopressin reduces nighttime urine output. For children older than 8 years, the dose of oxybutynin is twice a day.
Bladder training therapy
In this type of bed-wetting treatment, a child is encouraged to hold his or her urine for longer periods of time during the day to put the pressure on the urinary bladder, which in turns strengthens the bladder muscles. The bladder-retention training has been shown to work well when combined with a bed-wetting alarm.
Other bedwetting treatments for bedwetting include psychotherapy, hypnosis, diet therapy, and acupuncture.
They are not proven to be effective in managing bedwetting in those children who suffer from emotional problems and/or obesity.