Updated 19 February 2019

When children wet their bed: what the doctor would do

Dr Owen Wiese explains how important it is to remember that children do not have control over bedwetting, and that it can be a very complicated matter.

You've done it all: covered the mattress in plastic, decreased your child's water intake before bedtime, tried every single over-the-counter medication for bedwetting, but nothing seems to solve the problem. 

There are many myths about why children wet their beds. "The child is lazy" is one of the most popular ones, but is completely untrue. For the parent, bedwetting is a practical problem, but for the child it is much worse and can lead to major issues, including a feeling of shame, social issues and the worry that something is the matter with them.

Read: How to treat bedwetting

Most children under the age of five wet their beds. However, by the age of 10 95% of children should be dry.

When visiting your doctor, you will be asked the following:

Your child's medical background, including:

1. Medication your child uses

2. Your child's toilet habits during the day

3. Number of wet and dry nights (try to keep a diary) 

4. Emotional stressors at home and at school (be prepared to discuss this in great detail)

Your doctor will also do a full physical exam on your child. This will include examination of the abdomen, external gentalia, neurological examination and evaluation of the spinal column.

Side room investigation will include a urine dipstick to check for any signs of urinary tract infection.

Your doctor will discuss the most common causes of bedwetting. It is important to remember that your child does not have control over the bedwetting problem. Bedwetting can be a very complicated matter and is often investigated by a specialist team. This may include a psychologist, urologist, paediatrician and psychiatrist.

Treatment depends on the cause. It is important for parents to realise that bedwetting as such is not a surgical condition unless there is an underlying condition that leads to bedwetting. Treating bedwetting usually requires medication and behaviour modification therapy (like alarm therapy). Psychological and psychiatric intervention is therefore required. Medication like desmopressin, together with behaviour therapy are the treatment of choice. Expect your doctor to refer you to a specialist team.

Read: Bedwetting stems from physical causes, not psychological

Bedwetting can be a very distressing problem, but it is important to understand that your child has no control over the episodes. Punishment of any sort will only worsen the problem.


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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