Exams and Tests

Any child beyond age 6 or 7 who continues to wet the bed may need to be evaluated by a doctor. The evaluation should include a urinalysis.

A medical history and a physical exam are also part of a medical evaluation of bed-wetting. If you are having your child evaluated for bed-wetting, for a week or two before your visit, keep a diary that lists when wettings occur and how much urine is released.

In some cases, further testing may be needed. Tests may include:

• A urine culture to find out if a bladder or kidney infection is present.
• Psychological testing, if emotional stress is suspected.

If a child has uncontrollable wetting both at night and in the day, other tests may need to be done.

Bed Wetting: Should My Child See a Doctor?

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. For more information, see the Home Treatment section of this topic.

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. Medical treatment may help your child wet the bed less often or help him or her wake up to use the toilet more often.

If a child relapses after stopping a successful therapy, that same therapy usually is repeated.

Treatment for bed-wetting is based on the:

• Child's age. Some treatments work better than others for children of a specific age group.
• Child's and parents' attitudes about the bed-wetting. If gaining bladder control is seen as a normal process, it is usually easier for the child to stop bed-wetting.
• Home situation. If the child shares a bedroom with other children, certain techniques to arouse the child, such as dry-bed training or some moisture alarms, may not be practical.

Treatment for bed-wetting may include:

• 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 antidepressants. These medicines increase the amount of urine that the bladder can hold or decrease the amount of urine released by the kidneys.

Treatment for bed-wetting may be helpful if bed-wetting is affecting a child's self-esteem, performance in school, or relationships with peers.

The best solution is often a combination of treatments. Below are some suggestions for treatment options according to the age of your child.

• Ages 5 to 8: Help your child understand that wetting the bed is a normal part of growing up. Encouragement and praise may be all that is needed to help your child wake up before wetting. Children in this age group should be praised for dry nights and should take an active role in cleaning up after wetting.
• Ages 8 to 11: If your child still wets the bed, a moisture alarm may be a successful treatment option. It can be used in combination with occasional use of a medicine such as desmopressin, which can be helpful for social events such as camp or sleepovers.
• Age 12 and older: There can be significant emotional effects if bed-wetting persists at this age, so treatment can be more aggressive. If consistent use of moisture alarms does not work, the doctor may suggest medicine.

For more information, see:

Bed-Wetting: Should I Do Something About My Child's Bed-Wetting?

What about treatment for daytime wetting?

Accidental daytime wetting may be a normal part of a child's development, or it may point to a medical condition. Talk to your child's doctor if your child has daytime wetting.

What To Think About

Studies show moisture alarms to be the most effective single treatment for bed-wetting.

Medicines for bed-wetting are usually used in combination with other methods of treatment. They are not as successful as other treatments in helping children gain complete bladder control. Medicines may be most helpful in these situations:

• To help older children control bed-wetting for short periods of time, such as for camp or overnight trips
• To treat bed-wetting that is related to a stressful event, such as the divorce of the child's parents or the birth of a sibling

Often a child who has responded successfully to treatment will begin to wet again after treatment has stopped. But most children who relapse can be treated successfully with a repeat of the original program, especially if that program is based on behavior modification, such as using a moisture alarm.