Bed wetting and Strong Urine Smell

My 12 year old son still has bedwetting. I have noticed that his urine smells strong and his room stinks. Why is this and what do you recommend?

Urine odor is related to the volume and concentration of substances that are normally excreted by the kidneys. Things that normally affect urine odor include:

Dehydration– Concentrated urine smells worse than dilute urine.
Length of time urine is exposed to air– If your son wets early in his sleep cycle, by morning the urine odor will be worse.
Amount of urine-A typical 12 year old can hold 14 ounces (almost 2 cups) at once; this large amount of fluid is enough to saturate bedding.
Foods and medications– Vegetables such as asparagus or certain vitamins, break down into smelly chemical components when they are metabolized.

The following two causes of strong urine smell should be evaluated by your health care provider. He or she can do a simple urine dip in the office to make sure neither of these is affecting your son. Further testing may be warranted if the dipstick is positive.

Bladder infection-Especially if accompanied by cloudy or bloody urine, low fever, pain or burning when urinating, frequent sensation to urinate, cramping or pressure in lower abdomen or back.
Diabetes-Rarely can cause bedwetting and large amounts of urine to be produced.


Use enzyme based cleaners-Covers, clothing and bedding sometimes still smell after being washed. The organic odor-causing bacteria can remain in the cloth, even after washing in hot water. Enzymatic cleaning products, such as DP, break down the urine proteins and allow them to be removed. Then the odor is finally eliminated as well.

Good hygiene-Make sure your son showers in the morning to remove the urine from his skin. Protective lotion will help with any rashes he may have developed from the urine contact. Kids who wear pull-ups at night should shower in the morning, too.

Mattress protectionZippered vinyl mattress covers stay in place and can easily be sprayed off each morning with an enzyme based cleaner such as DP or Odorzyme. Odor-eliminating underpads, which lie on top of the sheet, are recharged by washing with chlorine bleach, eliminating odor causing germs.

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Daytime voiding and drinking has no effect on bedwetting

Traditionally, when a parent brought up bedwetting to their health care provider, they were given bladder training advice as first line therapy. This advice focused on regular voiding, sound voiding posture and sufficient fluid intake during the day. It was recommended that the family try this before any other treatment was initiated.

A new study looked at whether this advice influenced the number of wet nights and/or improved the success of subsequent bedwetting alarm therapy. Forty children with bedwetting were randomized into two groups: one group to receive bladder training advice for one month, then alarm therapy and the other group just to start bedwetting alarm therapy immediately.


Basic bladder advice, by itself, did not reduce the number of wet nights and the end result of alarm therapy did not differ in those that had waited a month to start, while practicing the bladder advice.


Based on the results of this small study, the recommendation that all children with bedwetting practice bladder training can no longer be supported. There is no reason to wait to begin bedwetting alarm treatment. This can be offered as first line therapy to children with bedwetting.

Although the healthy patterns of fluid intake and regular urination during the day can be encouraged in any child, according to the results of this study, parents should not be given false hope that just doing this will resolve bedwetting.

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Tips for Wetting at School

The start of the new school year can bring about unexpected surprises, such as wetting or leaking in the underwear in a child who has been dry. The most common cause of new wetting is not noticing the need to use the bathroom until it’s too late. A few drops of urine in the underwear are something you begin to notice, especially when doing a few days of laundry.

Here are a few tips to help stop wetting at school:

Talk to your Child
• Ask about bathroom policies at school. Are they asked to “wait” frequently? Are there assigned toileting times for the class or do they go individually?
• Ask about the bathroom specifically. Some children voice concerns such as “It’s too dirty. It smells funny. It’s dark and I can’t reach the light.”
• Is your child worried that they will miss something important while in the bathroom and won’t be following the “rules” if asking to go?

Talk to the Teacher
• Learn about the rules, location of bathroom, ask teacher for suggestions she has used in the past.
• Inform her/him that your child is having a problem. A busy teacher may not notice wet clothes unless it’s a large spot or even know your child is having difficulty staying dry.
• Allow child to have a water bottle in the classroom. Just because a child needs to urinate frequently or urgently, it does not mean they are drinking too much.

Associated Problems
• Constipation can contribute to wetting problems. The goal should be a soft stool every day or every other day.
• Urinary tract infections or vaginal irritation can cause frequent voiding, discomfort, and leaking. If suspected, have your doctor rule this out.
• Is your child fearful, embarrassed and hiding evidence? Reassure them that you will work on a solution to this problem together and getting soiled clothing washed is the best action. Kids don’t smell themselves so reasoning that they will address this because of the bad smell is not the case.
• Not drinking enough during the day. Concentrated urine can be more irritating to the bladder. Dilute urine and voiding regularly and frequently is healthier.

• Make sure your child takes their time in the bathroom. Girls should spread their legs and wipe from front to back. Make sure their clothing is easily removed, zipped, or buttoned. Dark colors show less stains.
Daytime waterproof, washable underwear can prevent embarrassing accidents.
• Arrange with the teacher to have unlimited bathroom privileges and access to enough fluids. Try to improve bathroom usability.
• Start a timed voiding program. This is when a child uses the bathroom every 2 hours, even if they don’t feel like they have to go. Use a discreet vibratory reminder watch, such as the Rodger Vibrating Watch, to remind kids of this. Don’t expect a busy teacher to do the reminding.
• Be patient. Know that support, and not punishment is more helpful. Regular bathing and laundry can help kids stay odor free.

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