Problem Cause Management
Large wet patches within the first few hours of sleep Low levels of arginine vasopressin (AVP)
  • Desmopressin from age 5, withdraw gradually.
  • Consider restriction of fluid intake 2hrs before bedtime.
Urgency / frequency during the day Bladder instability
  • Oxybutynin from age 5 (preferably 7).
  • Increase fluid intake during day and regular toileting to encourage regular and complete voiding.
Doesn't wake when full bladder Poor arousal from sleep to sensation of full bladder
  • Enuresis alarm

Enuresis Resource and Information Centre (ERIC)

Management of bedwetting in children and young people: summary of NICE guidance (2010)

Enuresis (2011)