Teens and bedwetting

I am responding to TU, whose 13 year old son continues to experience nightly bedwetting. Otherwise, he is healthy and well adjusted, has been checked out as urologically normal by an urologist, and is on no regular medications. He has tried DDAVP medication, without success, and currently avoids sleepover situations. He and his mom do daily laundry and he usually soaks sheets and blankets. He has no issues in the daytime and no constipation but a family history in an uncle of wetting through his teen years. What can they do to end this?

I see many children with bedwetting who are 13 years or older. Many describe feelings of hopelessness or frustration with not knowing what to do to end this quickly. 97% of children and teens with primary nocturnal enuresis (bedwetting that has always been there) have no urologic abnormalities.

Since there is often not an easily identifiable cause, families do not know where to turn and have mostly tried measures such as limiting fluids, reward or punishment, setting alarm clocks, or waking when the parents go to bed. These measures will sometimes enable the teen to have a dry night, but do little to insure permanent dryness.

The good news is that bedwetting alarms work as effectively in teens as they do in younger children. It usually takes teens a little longer to get to complete dryness, but a few extra weeks to change a behavior that has been going on for years is quite tolerable.

I've found that the key to success for teens and older children is to use an alarm that is easy to use and acceptable to them. The wireless alarms (such as the Rodger and Malem Wireless) are my recommendations for teens for a couple of reasons.

One, wearable alarms require that the user wear a shirt so that the alarm unit can be attached. Many teen boys sleep without a shirt so that could be a roadblock to consistent use.

Two, many tech savvy teens quickly disconnect the sensor from the wearable alarm unit and roll over and go back to sleep. They rarely remember this is the morning and wonder why their alarm is disconnected but their bed is wet and they don't remember getting up. A positive feature about the wireless alarms is that the teen must get out of bed to turn off the alarm. Since the receiver is located in an outlet or on a dresser, it will continue to sound from that location until it is turned off.

A third reason why wireless alarms are recommended is that there are few steps to attach them. The Rodger alarm comes with two pair of specialized briefs. (More can be purchased). The teen simply puts these on when getting in bed. The transmitter stays plugged in the wall or on the nightstand. The Malem wireless alarm fastens to underwear he already owns (close fitting, not boxers) and can be an advantage if your family doesn't do laundry very often. If there is no wetting, the underwear go back in the drawer. If wetting occurred, the underwear is laundered with the sheets. I have all my patients sleep on a waterproof, absorbent overlay on top of their sheet. When the alarm sounds, It's easy to remove the wet overlay and go back to a dry bed.

Even with teens, the parent's role is important initially. Listen for the alarm and make sure that your son is getting out of bed and walking to the bathroom as the correct response. The quicker he learns how to respond to the bedwetting alarm, the more quickly he will be on the road to dryness.

One last point is to make sure the alarm is worn long enough. Having 14 consecutive nights of dryness is important before beginning to use the alarm every other night for 14 nights. Often, my teen patients are so excited to have 4 or 5 dry nights in a row that they stop their alarm use prematurely. Wet nights begin occurring sporadically and further progress is delayed. Wireless bedwetting alarms can be used for any age child but they are particularly well-suited for teens.

Persistence and patience will help insure success.