Children's Health

Other treatments often are used alone or in combination to treat bed-wetting. These treatments usually are tried before medical treatments, such as medicines. All of these treatments involve several steps, including:

• Educating the parents and child about what is normal and expected for children as they grow and about how the urinary system works.
• Empowering the child to believe that he or she can overcome the problem in time.
• Training the child to stop wetting the bed (through behavior changes and conditioning) or helping remove the cause of the bed-wetting (for example, through counseling or hypnosis if stress is the cause).

Sometimes a device such as a moisture alarm is part of the training (conditioning) process.

Other Treatment Choices

• Praise and encouragement (motivational therapy) may be successful in stopping bed-wetting when used in combination with other treatments such as moisture alarms.
• Counseling (psychotherapy) may be helpful for the child with secondary enuresis or for bed-wetting that is caused by emotional stress. Psychotherapy involves talking with a trained counselor. The counselor helps the child identify and deal with the emotional stress that may be causing him or her to have accidental wettings. The goal is to reduce or help manage the stress or to prevent stress from occurring.
• Hypnosis (hypnotherapy) has helped some children who wet the bed and may be especially effective when stress is the cause.

Various methods of behavior training have been used to teach a child bladder control:

• Self-awakening training involves having the child practice getting out of bed to go to the bathroom. It is mostly to be used for children older than 6 years.
• Dry-bed training consists of following a strict schedule for waking the child up at night until he or she learns to wake up alone when needed. The dry-bed training program is implemented over 7 nights.
• Bladder-stretching exercises are done to help increase the amount of urine that the bladder can hold (bladder capacity). They teach the child to hold urine for longer periods of time.

What To Think About

• Motivational therapy requires a longer period of treatment than other treatments for bed-wetting. It works best with older children (older than 6) who are eager to stop wetting.
• Moisture alarms are thought to be the most effective treatment for bed-wetting and are often the first choice of doctors. Moisture alarms are usually used for children older than 7.
• Before hypnosis therapy is started, the child needs to be evaluated for emotional problems that may need to be treated by other methods. Psychotherapy along with hypnosis can help children deal with stressful situations.
• Even if treatment seems to work, bed-wetting will often return after treatment is stopped. Most children who relapse can be treated successfully with a repeat of the original treatment, especially if treatment includes motivational therapy and a moisture alarm.