Enuresis

Basic advice for parents:

Encourage children to empty their bladder before bed and not to drink large amounts in the evening.
Enable them to locate the toilet without difficulty; if the bathroom is far from the bedroom, consider placing a potty in your child's bedroom.
Use a mattress protector and allow them to help clean up in the morning. Make sure they wash every day to prevent the smell of stale urine lingering.
Be supportive; educate siblings and other people living in the home not to tease.
Let children know that it's not their fault.
Go back to see your child's physician if enuresis returns.

Advice concerning specific therapies:

There is a need to persevere with therapy in order to determine whether it will be effective. Treatment with alarm therapy is often slow to start showing signs of success, so families need to be told that therapy should be continued for at least 12 weeks before any re-evaluation is done.
The patient and the family should be warned about possible water intoxication and hyponatremia related to desmopressin administration. This can be avoided by limiting the water intake during and around the time of administration. It is important to shift drinking to earlier in the day.
Oral desmopressin has a 1-hour onset of action, so a typical recommendation is for the child to take the medication 2 hours before bed and to stop drinking at that point. The child should be encouraged to urinate just before going to bed.
It is helpful for the patient and family to be informed of the typical natural course of enuresis. Explain that recurrence is common, but in many patients spontaneous resolution does occur at a rate of 5% to 10% per year.[1]

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