Check that there is nothing seriously wrong. Your doctor will ask you questions, especially about whether you have wet the bed since childhood, or whether it is a new problem. He or she may do simple urine tests for infection and for diabetes. Your doctor may also check that there is nothing physically wrong with the bladder system. This might require a referral to a urologist and/or a bladder ultrasound scan.
Bedwetting alarms (enuresis alarms) are used for children who wet the bed, but they can also work for teenagers and sometimes for adults. Modern types are worn between two pairs of pants, so they are small and discreet. If you have a partner, they will obviously have to be understanding and as motivated as you are. Your family doctor can advise you about obtaining an alarm. If the alarm has not produced any improvement after four weeks, talk to your doctor about the possibility of combining it with desmopressin (see below).
Medications are available on prescription from your family doctor.
Desmopressin is the best medication and is taken as a tablet, a nose spray or a wafer that dissolves on the tongue (‘melt’). It works by concentrating your urine so that there is not such a large volume to cope with. Although it stops bed-wetting completely only in less than one-third of people, most find it reduces the number of wet nights. It does not cure the problem – when you stop taking it, the bed-wetting often recurs – but it is safe to take it over a long period.
Imipramine is a medication that somehow helps the bladder to hold more urine. It used to be popular, but is now used only if desmopressin has not helped. It has some side effects and is dangerous if too much is taken, so is usually only prescribed by a specialist.
Tolterodine and oxybutynin calm overactive bladder muscle. They may be helpful if you have daytime wetting) as well as bed-wetting, and have to rush to get to the toilet (urgency). They can cause side effects, such as dry mouth and constipation, but these can be minimized by taking the medication at night. If desmopressin has not worked, they may be useful in combination with imipramine, but usually under the supervision of a specialist.
First published on: embarrassingproblems.com
Reviewed and edited by: Dr Kevin Barrett
Last updated: May 2021