Your decision on whether to schedule a doctor visit to discuss your child's bed-wetting will involve several considerations, including your child's age, how long he or she has been wetting the bed, and whether you suspect an infection or another problem is causing the wetting. Consider the following when making your decision:

• Your child will probably stop wetting the bed on his or her own. Gaining bladder control is a normal developmental process that takes longer in some children. Most of the time your health professional can tell without any tests whether your child's wetting may be due to a medical problem.
• If your child has symptoms such as fever, abdominal pain, or pain during urination, the wetting may be due to a urinary tract infection. If so, you should schedule a doctor visit.
• If your child has been dry for 3 months or longer and has begun to wet the bed again, the child may have a bladder infection. Stress can also cause a child who has had bladder control to begin wetting again. You may want to schedule a doctor visit.
• A physical exam for bed-wetting may be stressful or anxiety-provoking for your child. Furthermore, if the exam doesn't reveal a problem (which is most likely the case), your child may feel ashamed or guilty. Consider the effects of taking your child to a health professional as you make your decision-your child may feel that there is something wrong with him or her or feel responsible for the bed-wetting.

When is it normal for a child to gain bladder control?

Children gain bladder control at different ages. Although most children are able to control their bladders by age 5 or 6, some children take longer. A few may still wet occasionally until age 10 or 12. If a child is otherwise healthy, has never been dry, but seems to have more dry nights as he or she gets older, the bed-wetting most likely does not have a medical cause.

Exams and tests rarely show a physical cause for bed-wetting.

What can an exam for possible causes of bed-wetting show?

The health professional will examine the child and ask questions about the bed-wetting. A careful medical history and physical exam usually are all that is needed to reassure you and the child that there is nothing physically wrong. The health professional may be able to help you identify possible sources of stress that may be contributing to the child's wetting.

Sometimes a urinary tract infection can cause accidental wetting, especially if a child who has been dry starts to wet again (secondary enuresis). Urine tests commonly are done to help diagnose a possible infection.

If there is a medical reason for a child's wetting, there usually are signs other than bed-wetting. These signs, such as an abnormal urine stream, can often be found with a physical exam. In rare cases, the health professional may notice something unusual about the child's urine stream (spraying, stops and starts), and he or she may suggest some tests. Structural problems in the urinary tract are rarely the cause of accidental wetting.

What new problems could develop if my child has tests?

The history and physical exam for bed-wetting may be stressful for your child and may make him or her anxious about wetting the bed. Furthermore, if the exam doesn't reveal a problem (which is most likely the case), your child may feel ashamed or guilty. Consider the effects of taking your child to a health professional as you make your decision-your child may feel that there is something wrong with him or her or feel responsible for the bed-wetting.

Reassure your child that there is nothing to be ashamed of and that it is normal for some children to take longer to gain bladder control than others.

What are the risks of not having my child tested?

There is very little risk to not having your child evaluated for possible causes of the bed-wetting. You and your health professional may agree to wait a few months and see whether your child begins to gain better bladder control and have more dry nights. If things don't go as you expect, you can discuss having your child evaluated at that point.

If you need more information, see the topic Bed-Wetting.

Your choices are:

• Wait and manage the bed-wetting at home.
• See a health professional to check for possible causes of the bed-wetting.

The decision about whether to schedule a doctor visit to discuss your child's bed-wetting takes into account your personal feelings and the medical facts.

Discussing your child's bed-wetting with a doctor

Reasons to schedule a doctor visit

Reasons not to schedule a doctor visit

Your child has symptoms such as fever, abdominal pain, or pain during urination that may indicate a urinary tract infection. Your child had been dry for 3 months or longer and has begun to wet again. This may be a sign of a bladder infection or stress. You are concerned about how bed-wetting affects your relationship with your child or your child's relationships with other children. You are concerned that your child age 7 or older should have stopped wetting by now. Are there other reasons you might want to schedule a doctor visit to discuss your child's bed-wetting?

Most children stop bed-wetting on their own. Children stop bed-wetting at different ages. Gaining bladder control is a normal developmental process that takes longer in some children. An exam may be stressful for a child and may make him or her anxious, uncomfortable, or ashamed about wetting the bed. There is rarely a medical cause for bed-wetting. If there is a medical reason, signs like an abnormal urine stream or symptoms of infection will usually be present. Are there other reasons you might not want to schedule a doctor visit to discuss your child's bed-wetting?

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about scheduling a doctor visit to discuss the bed-wetting. Discuss the worksheet with your health professional.

Circle the answer that best applies to you.

I am worried or concerned about my child's bed-wetting.	Yes	No	Unsure
My child is worried or concerned about the bed-wetting.	Yes	No	Unsure
One or both of the child's parents wet the bed as children.	Yes	No	Unsure
My child is under stress or reacting to stress in the parents' lives.	Yes	No	Unsure
I think it would help my child to know that there is no medical reason for the bed-wetting.	Yes	No	Unsure
I've tried home treatments to stop the wetting.	Yes	No
My child has other signs or symptoms that might explain the bed-wetting.	Yes	No	Unsure
My child had a previous period of 3 months without wetting the bed.	Yes	No	Unsure

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to schedule or not schedule a doctor visit.

Check the box below that represents your overall impression about your decision.

Leaning toward scheduling a doctor visit

Leaning toward NOT scheduling a doctor visit

Author	Amy Fackler, MA
Author	Debby Golonka, MPH
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Peter Anderson, MD, FRCS(C) - Pediatric Urology
Last Updated	November 14, 2006