Dear Karen and Ben, it must be incredibly frustrating and disheartening when you feel like you’ve tried it all and still no success. There are a few things to think about … firstly, how old was your son when you first tried the conditioning alarm and how long did you try it for? It is certainly true that conditioning alarms do not work for everyone although we do find their success is contingent upon how supported families are in using them, as well as the level of commitment on behalf of both the child and parents. If you do decide to revisit this treatment I would strongly recommend that you tackle this with the help of a continence advisor. An alternative form of treatment that does not appear in your long list of efforts is hypnotherapy – while this has not received research support, anecdotal reports from parents attest to its success in this area. Hypnotherapy can also be used in combination with a conditioning alarm, as it is designed to help your son to wake-up in response to the alarm. You can try and increase his bladder capacity through fluid management, which involves stretching out the fluids he drinks over a 24-hour period. Encourage him to drink water approximately every 2 hours tapering off in the evening – he should be consuming approximately 1.5 litres per day. It is not unusual for children to drink very little during the day while at school and then consume the majority of their daily fluid intake in the afternoon, placing additional pressure on the bladder at night. In the meantime, we also need to think about how to try and minimize the impact his bedwetting is having on his social life and self-esteem. Holding the sleepover at your house is a good way to begin building his self-confidence. You can help him to feel more comfortable and self-assured by practicing getting ready for bed and finding ways to disguise his DryNites. Wearing an over-sized pyjama pant or nylon trackpant is one option – some children find wearing underpants over the top of their DryNites also reduces any sound. You could also consider using a medication designed to reduce urine production. This should only be used in the short-term but can be an effective way to manage his bedwetting for things like sleepovers. You should discuss this with your doctor when you make your appointment.

Regards,
Dr Cathrine

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