Bed-Wetting

Bed-Wetting Diagnosis and Treatment

Bed-wetting, also known as nocturnal enuresis, is a common condition among children. While many outgrow it naturally, sometimes an underlying medical or emotional cause may be involved. Diagnosis and treatment focus on understanding the cause and providing support for both the child and family.

Diagnosis

Depending on your child’s situation, the healthcare professional may perform tests to identify any underlying cause of bed-wetting. A treatment plan is then created based on the findings.

Diagnosis may include:

• Physical exam

• Discussion of symptoms, fluid intake, family history, and bowel and bladder habits

• Urine tests to check for signs of infection or diabetes

• X-rays or other imaging tests of the kidneys or bladder to look at urinary tract structure

• Other urinary tract tests or assessments if needed

Treatment

Most children outgrow bed-wetting on their own. However, if treatment is necessary, parents and healthcare professionals can work together to decide what is best for the child.

If your child is not especially upset by occasional wet nights, simple lifestyle changes may be effective. These may include avoiding caffeine, limiting liquids in the evening, and using the bathroom right before bedtime.

When lifestyle adjustments don’t work, or if your child feels anxious or embarrassed about bed-wetting, additional treatments may be recommended. If underlying causes such as constipation or sleep apnea are suspected, these should be addressed by a healthcare provider.

Common treatment options include moisture alarms and medication.

Moisture Alarms

Moisture alarms are small, battery-operated devices connected to a moisture-sensitive pad on your child’s pajamas or bedding. The alarm sounds when wetness is detected, helping the child wake up and stop urinating.

These devices are available at most pharmacies without a prescription.

Moisture alarms can take time to work. Improvement may begin after 1 to 3 months, and dry nights may occur after up to 16 weeks of consistent use. They are safe, effective for many children, and carry minimal side effects. However, they may not always be covered by insurance.

Medicine

If behavioral and alarm methods do not help, medication may be prescribed for short-term use. Medicines can help reduce urine production at night or calm bladder activity.

• Desmopressin (DDAVP): This medicine slows down urine production during the night. It is available as an oral tablet for children aged 6 and older. The nasal spray form is no longer recommended due to safety concerns. Desmopressin should not be used if the child has fever, nausea, or diarrhea, and it’s important to follow dosage instructions carefully.

• Oxybutynin (Ditropan XL): This medication helps relax the bladder muscles, especially useful for children who also experience daytime wetting. It is generally used along with other treatments and is considered when other options fail.

Sometimes a combination of medicines may be prescribed. However, medicine does not cure bed-wetting—it only helps manage the symptoms. In most cases, bed-wetting may return once medication is stopped and typically resolves naturally with age.