What your doctor can do

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 will do simple urine tests for infection and for diabetes. Your doctor will also check that there is nothing physically wrong with the bladder system – this may require a hospital referral to a consultant urologist and/or a bladder X-ray or ultrasound scan.

Bedwetting alarms (enuresis alarms) are used for children who wet the bed (see bed-wetting alarms), 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 or, in the UK, you can buy one from ERIC (see useful contacts). If the alarm has not produced any improvement after 3 months, talk to your doctor about 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 or nose spray. It works by concentrating your urine so that there is not such a large volume to cope with. It is especially useful if you stay away from home, or if you have a bed partner. Although it stops bed-wetting completely 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.

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.