Bed wetting. Old or need medication.

Preliminary management focusing on behavioral modification and positive reinforcement is often helpful. Bladder training exercises are not recommended. The only therapies proved to be effective are alarm therapy and treatment with desmopressin acetate or imipramine. Enuresis per se is not a surgically treated condition. Initial management includes the following: Caring and patient parental attitude since the child has no control over the wetting Behavioral modification with positive reinforcement Explanation of the probable cause of the enuresis Keen attention to establishing and maintaining a normal daytime voiding pattern, normal bowel pattern, and normal hydration If following this approach for up to 3 months does not result in dryness, either alarm therapy or pharmacologic therapy should be considered. Alarm therapy should be considered for every patient. However, if the child is still wet after a minimum of 3 months of consecutive use, alarm therapy can be discontinued and considered unsuccessful. Failure does not preclude future successful treatment once the child is older and more motivated. Pharmacologic therapies include the following agents: Desmopressin acetate (the preferred medication for treating children with enuresis); combination of alarm therapy with desmopressin therapy may yield dryness not achievable with either therapy alone Anticholinergic agents such as oxybutynin chloride and tolterodine (especially in patients with overactive bladder, dysfunctional voiding, or neurogenic bladder); the combination of desmopressin acetate and oxybutynin chloride may be efficacious in children with overactive bladder or dysfunctional voiding who show daytime response to anticholinergic therapy but continue to wet at night...Consult nearest pediatrician they will do the needful Regards