Nocturnal Enuresis/Bedwetting in 15 year old

[Madamlulu]

I'd appreciate any advice as I'm now so worried about this. Please be kind.

DS 15 has NEVER been completely dry at night. I honestly don't know where to start and try to explain.

From a baby he was potty trained at 2 &1/2 and almost completely dry from that time during the day (with the very occasional/ normal toddler accident). He just never was dry at night and so this continues to now and he is starting to look like an almost grown man and I'm so lost with what to do.

We have tried;

• alarms when he was younger tried these loads. The ones that went in his underpants, the one he laid on. He DOES not wake up to the alarm but we tried me waking him up which he is delirious but then goes to the bathroom - had absolutely no success.

• we went to see someone via NHS when he was about 9. Totally useless. Insisted on asking DS for his opinions who is so embarrassed and so was saying it doesn't happen very often (it happens probably 50% of ALL nights). They then concluded that he was ALMOST there. Totally useless and after a years wait was soul destroying.

• medication from GP when he was going

On a trip. Didn't work

• I then left it for years thinking I had no hope but earlier this year took him to see a private urologist who said we had to go through a series of steps. The first being to stretch his bladder. This involves him drinking loads of water. He has ADHD and is hopeless at remembering and being reliable and when the doc said this I was sceptical that it was even the problem and also said 'it's not going to work as we have to rely on him to drink the water and he forgets' and the doctor then spoke to him and DS promised the doctor he would drink more than 2 litres of water a day .he doesn't and hasn't. I don't know whether to even go back as feel like we failed at the first hurdle.

The problem with the above is I actually have no faith . Why would trying to stretch his bladder even work? He CAN hold urinie in during the day but he simply cannot wake up in the night and so I don't see why this is key. I told the doctor this and he said it is just the first part of the step and then said 'a-% of adults wet the bed so nothing might work'

I feel like I'm failing him but he's a 15 year old outgoing boy with a social life! I can't control what he eats and drinks and this sort of thing now- he's not a toddler.

Sorry this is a bit lost but I just don't know where or how to get help. Going private is not something we can really afford but I'm prepared to borrow money if that's what's needed to see someone to get the right help but I just don't know what that it..

Btw he is a bright boy but the ADHD causes him attention difficulties and he now has medication for this: he was only diagnosed with this this year and I thought 'bingo!' This is related and I kind of feel like it might be - BUT the team at the ADHD clinic dismissed that. I feel like nobody can really help my child and they just look at process and not really HIM.

FYI he wears pull up pants which only hold a fraction of the urine in and the amount of washing is immense these are not small bladder wees! . I can cope with all of that if I can just do something to feel like I'm not failing him as I really feel like I am right now.

I really feel like this could be one of 2 things;

1 physiological - he produces way too much urine in the nighttime than appears to be normal. He observed this himself when he stayed up all night once at a friends sleepover and was scared to go to sleep as he would wet the bed. He said he kept going to the loo and peeing loads - that's normal

2 linked to his brain signal not waking him up.

I would try what the urologist said. Yes it might not work, but I wouldn't have thought there was any harm in trying. Try reminder alarms or those water bottles with times on them to get your son to drink the amount that was suggested.
If it doesn't work, at least you can then go back and say that. Whereas at the moment, your son hasn't done what was suggested so if you go back they're not going to say much else.

I don't have time for a full post, but DD is 13 and still has accidents, overactive bladder the specialist said I think. She takes desmopressin nightly and it works for her.

Does he have any trauma at all? DSis used to bedwet until she was 14 and it was due to trauma.

Thanks for the replies.

No trauma at all.

The meds you suggested are the ones we tried that didn't work. Did you see a specialist to get those prescribed please?

How long did you last in the alarms? My ds used to wet every night. Slept like the dead. The alarm would wake me up 3 doors away, I would then go into his room and trickle water on his face which was the only way I could wake him. He'd go to the loo, get changed, go back to bed. It took 2 months of this but then one day it just clicked and we've never looked back.

This is interesting. We absolutely didn't persue it for 2 months. Maybe we did for 3 weeks and then stopped and then tried again (several times).. I'd be happy to try again and give it longer of course and reading this gives me hope! Thank you. Which alarm did you use? Did you not use pull ups with the alarm?

If he's producing large amounts of urine at night, that sounds like he needs to get on the desmopressin again. That's a hormone that should be produced naturally that concentrates your urine at night so you produce a much smaller, more concentrated amount and your bladder can store it all till the morning. If he's not producing it or not in enough quantity then he will be producing too much overnight in the first place. How long did he try it for? could he try a bigger dose?
then with the alarms, did he sleep through them? Was it the ones you clip to clothes? We used an alarm with my youngest and it did take some perseverance to get through it. I was also a teenager who wet the bed and needed medication to get on top of it in the end. It's worth pursuing whatever you can because it's hideous to be in that position as a teen.

Have you tried hypnotherapy? I’ve heard some success stories especially for older teens. Not tried it personally with DS though, as he only wets the bed when he’s very stressed. Are the pullups big enough so that it catches most of the wee? Does he have a waterproof bed cover?

We used pull ups but made him get up and change. The alarm was a wireless 'in the pants type called eclipse dri sleeper or similar. Their documents suggested the face wetting to wake them. Shaking him awake took aeons and didn't seem to be as good.

How long was he taking the desmopressin last time? Our DS was on it for a good 8 months before being weaned off it.

Is he constipated? Our DS had trouble with constipation which exasperates the wetting problem. That needs to be sorted too.

Bottom line is that you need a referral for specialist help again and this time, be clear about the extent of the problem and follow their guidance to the letter.

You need to stick with the medical route. Don't give up because 'it doesn't work' you HAVE to make it work.

DS is 11 and has stopped night wetting but we are still with the continence service.

When we joined, his bladder capacity was measured as 150ml when expected for age was 300ml!! He could just about manage the frequency in the day but no chance at night hence the wetting.

Don't dismiss the idea of trying to stretch the bladder. If he's got a tiny bladder then that will make everything much much harder.

Age 15 bladder should hold approx 500ml.

Out of interest, get him to down 500ml then measure the next wee - I bet it's nowhere near 500ml.

DS also has overactive bladder and overactive muscles around it which are keeping it small. He's now on medication number 2 to relax these muscles which has sorted night wetting but still get lots of urgency in the day

He's been to Leicester for a kidney and bladder scan / test recently to see what's going on. We're awaiting results.

Stick with it - it doesn't sound like it's going to magically go away so you need to make it work.

Like others have suggested phone alarms, nagging, rewards, special marked bottles etc. build it into his routine so there's a trigger. Each drink should be 500ml.

Wake up - big drink
Arrive at school - big drink
1st break / big drink
Lunch - big drink
Home from school - big drink
Before dinner - big drink

Maybe a medication watch might help him remember to drink.

https://tabtime.com/products/tabtime-vibrating-alarm-watch-with-10-alarms

The pull ups catch some but not all the wee and the bed covers have to be changed and normally everything including duvet. Yes I have a lot of waterproof sheets - they take an age to dry so I'm constantly washing and drying these on rotation. The bed still smells of wee though regardless of this but we can only do our best. Poor thing doesn't realise it smells as he's so used to it and he showers every morning so doesn't smell himself

Not tried hypnotherapy but he'd be up for that if I could find someone .

Thank you. Will look into this.

Definitely not constipated. I ruled that out and forgot to mention we had done that

Update. I got DS to drink 500ml of water when he got in from school yesterday and hold it in until he was desperate. We then measured his wee and it was 400ml - which I don't think is too bad?

I think there is work to be done on that stretching though as someone mentioned at age 15 it should be 400ml so will do some work on the drinking but then ask to go back to the specialist or try the alarms myself instead.

Had a good chat with DS about working with me to help himself and told him I'd be nagging him about the water - he got
It and was up for the challenge so we are on a mission.

Thanks again for all the advice, just about to get him up for school and likely have to strip the bed - Groundhog Day again bless him!

Update;

Contacted the urologist's
Secretary who wrote back and said the service is no longer running and that there are no other paediatric urologist in the city we live in FFS once again the avenue we are trying to peruse has failed.

I've made an appointment with the GP - not
sure what I should ask for - If they refer us to the inconvenience service again it will likely take years (it did before).

I will pay privately if I can find someone. Don't want to as we don't have health insurance but also don't want to have him waiting as it's so damaging to his mental health.

I've also found a hypnotherapist who says he specialises in this. Will make an appointment.

In the meantime day 2 of drinking a lot of water and DS has been good with this. Interestingly last night after drinking loads he didn't wet the bed. I was surprised.

I wish there was a way we could easily get hold of the meds again but do you need to go through a specialist to get these do you think?
.

That's great that DS is on board - 400ml is a good start but still 80% where it should be so defo keep going with the water.

Our urologist was 45 miles away so it's not a failed option; it's just harder.

He may get a quicker referral as he's older and if you get onto the clinic as soon as you get the letter you can badger them for a cancellation.

We got the medication prescribed and then reviewed remotely whilst waiting for the actual scan so still made progress.

Keep going!! Make 2024 the year that you sort this out once and for all x

Hmm, I would be another to suggest the Desmopressin - very outing, but this afflicted me until I was late twenties (male, by the way), and nothing, but nothing worked! As you can imagine, it made my life miserable - the embarrassment, not being able to stay with friends or overnight anywhere, no sexual relationships, every aspect of my life was affected by it. I was resigned to suffering from this my whole life. Then, lo and behold, a urologist in London ( a saint in my eyes!), prescribed Desmopressin and, although the results were not instant, it miraculously worked! I took it for several months, then weaned myself off it and the problem has never reoccured. I would urge you to try Desmopressin again. Please! It might be the gamechanger for your son. I sincerely hope so.

Our GP prescribed desmopressin.

We have bought waterproof duvet covers. I put a normal cover over the top, but it means I only have to wash the normal cover daily, I wash the waterproof cover weekly ish, and I rarely have to wash the duvet. Game changer for me, as daily washing of the actual duvet was exhausting.

We use normal waterproof sheets to cover the bed, and then add these pads to the top. The pads are totally amazing - they're really thin, but somehow stop the normal waterproof sheet getting wet, so no more washing/drying the plasticky thing (which I agree is a total pain in the butt). The pass can be tumble dried too, and I have some that are knocking on 10 years old and are still bombproof. Clevermama pad - ClevaMama Waterproof Toilet Training Sleep Mat in Reusable and Washable Cotton for incontinence and accidents - White, 70x90 cm, 7216 https://amzn.eu/d/78qtPv9

Solidarity on the ND/incontinence/laundry treadmill

Also here for some solidarity. I have an ADHD son who has continence issues. Definitely get a load of those bed pads , they are tumble driable and so useful. and ask to be referred to the continence service again. You might qualify for free nappies for overnight?

We tried the alarm watch but my son just lost it!

I could have written this OP. We have tried alarms (he slept through them and hates them) desmopressin (sporadically - GP wouldn't prescribe more than a dozen - no way could we do months!) pull-ups (too small after he hit puberty) and oh the washing.... we spend our lives with drying duvets and absorbent sheets hung over bannisters and doors... DS drinks pints and pints but bladder stretching doesn't seem to have happened and the enuresis nurses he saw when he was 7-8 were useless and appallingly condescending - so bad he had a meltdown when seeing them, which was a factor in us getting him on a Dx pathway for ASD. He's now mid-teens and we've no real improvement.

OP if your hypnotherapist is anywhere near London, please would you PM me?

You can get desmopressin online from PharmacyPlanet without a prescription. Its £60 for 90 pills.

I had to do this for my daughter as the dr would only prescribe 5 at a time and while they were handy for a school trip or sleepover I wanted to try every night to try and get the hormone switched on.

You'll have to say they are for yourself or get your son to order them.

My daughter is nearly 17 and it's only really been the last 6 months that she's stopped wetting. We never got to see a specialist on the NHS and I had tried everything since she was about 6 but the only thing that worked was the tablet every night for 3/4 months.

If the pull ups aren’t containing even the majority of urine, request a referral to the continence service so you can try different incontinence products (not just pants/pull ups, but some find slips work better, you could also try adding a liner/pad inside the pant/slip and trying mats/sheets on top of DS’s bed sheet. And, if they don’t work, if necessary, something else e.g. a sheath) to find one that works better for DS. What works for one person doesn’t work for others.