Bedwetting past 16? What doctors say

When Monica’s son finally outgrew diapers at the age of three, she thought the bedwetting chapter of her life was over. For years, he woke up dry every morning.

Then, while in Class Six, the wet sheets returned. Today, at 17, he is still battling bedwetting, a condition that has turned boarding school into a source of anxiety and embarrassment. Monica took it lightly until her second-born son also started to wet the bed several years after he had stopped.

“When my 17-year-old son came home for the first term school holiday, he told me that he had stopped bedwetting, but I received communication from school that it was still happening. I did not even think about it when we were enrolling him in boarding school because it was a non-issue to us as a family, but I am now worried. During the holiday, I went to his bedroom at home and confirmed that his bedding was wet,” Monica says.

She had tried to stop her sons from taking liquids in the evenings, but the challenge persisted. Her second-born son is also facing stigma from his peers in boarding school for the same challenge.

“He is in Grade 10 and is a very intelligent student, but he always tells me he has no idea when he urinates while asleep. He wakes up shocked to find his bed wet every morning. I worry the stigma from his classmates could eventually affect his performance in school. Whenever I ask him to take his mattress outside to dry, he feels ashamed and becomes very quiet,” says Monica.

Read: Why is my teen still wetting his bed?

The mother of three sons, whose lastborn son is now in Grade Two, is now afraid that her lastborn, who has already been weaned off diapers, might also start wetting the bed later like his older siblings.

“I am afraid and stressed. I have asked around our family, but there is no history of adult relatives who have this problem,” says the 50-year-old mum.

Adolescent Medicine Physician at Aga Khan University Hospital, Dr Njeri Karianjahi, encourages parents and caregivers to seek medical review when an adolescent continues to wet the bed, or when bedwetting reappears after a period of dryness.

“Healthcare providers will explore the pattern and frequency of bedwetting, the presence of any pain during urination, urinary urgency or weak stream, bowel habits, and sleep quality. Emotional and psychosocial factors, such as stress at school, changes at home, or anxiety, and a family history of bedwetting, are also important to consider. It is important to be as open and as honest as possible during your clinical review,” says Dr Karianjahi.

She further notes that a physical examination helps identify any signs that may point to underlying causes.

“Simple investigations such as a urine test are often recommended to rule out infection. Imaging studies of the kidneys and bladder may be performed if there is suspicion of structural or functional abnormalities. These assessments allow the clinician to distinguish between periods where dryness was never fully achieved and where bedwetting reoccurs after a dry period, each of which may have different contributing factors,” adds Dr Karianjahi.

But Monica is not alone. *Jane,* whose daughter is 16, is also still bedwetting. She believes her daughter is a deep sleeper, which is why she cannot wake up to use the washroom at night.

“I cannot beat her, but I always talk with her and seek medical help. I’ve noticed that as she grows, the urine she produces at night increases in volume. That means we have to put the mattress out to dry every day,” says Jane.

Jane says talking with her daughter is not yielding fruit.

“I use a lot of wisdom when we are only two of us, but it is becoming too much, although she doesn’t wet the bed daily like when she was between the ages of 6 and 11.”

Read: When your spouse suddenly turns into a bed wetter

Jane and her husband have now made it a routine to wake up their daughter three times at night. She goes to bed at 8.30pm and the couple wakes her up every three hours to interrupt the deep sleep and reduce the quantity of her urine in bed.

“We allow her to drink as much water as she wants in the evenings. I sought medical help, but I wasn’t given any medication that could stop her from bed-wetting. We just had to be creative as a family.”

The challenges Monica and Jane are facing are similar to those *Mary* endured when her second born son continued bedwetting into his teenage years.

“I used to ask him, what happens when you find yourself urinating in bed? He said he does not know when or how it happens,” Mary says.

Mary chose not to be harsh, as she hoped her son would soon overcome the challenge.

“I started to talk to him, encourage him, and limit his intake of water or tea in the evenings. But even then, the challenge continued,” says the mother of four, whose firstborn daughter stopped bedwetting when she was three years old.

When her second-born continued to wet the bed past the age of 10, she became worried. She bought a Mackintosh, a highly absorbent waterproof baby bed sheet to protect her son’s mattress from night spills.

“I started telling him, ‘you are now a big boy, you need to stop this.’” When it became a nightly occurrence, I told him I was going to take him to the doctor to be circumcised. He got so scared,” she recalls with a laugh. The threat did not work. Her son would only sleep one night, then resume the following nights. Washing her son’s bed sheets became a daily routine.

“When he reached age 13, I made him wash his own bedding so that he could see what a burden it was to us.”

Mary also avoided going to places where she would be required to spend time with her son. She would only carry him along when she was going to her mother’s place.

“When we wanted to take him to boarding school, he refused, so we took him to a day school.”

At some point, Mary reached out to a doctor who prescribed an antidepressant drug.

“The doctor told me about the side effects, then advised me to give my son half of it on alternate nights, especially when he was not going to school. I only gave him for a week, then he complained about getting so tired during the day.”

When he stopped taking the medicine, the wet sheets returned and persisted until age 13. He is now 37 years old and no longer has the challenge.

According to Dr Chibanzi Mwachonda, a consultant psychiatrist and head of department at Coast General Teaching and Referral Hospital, bedwetting, known medically as nocturnal enuresis, has several causes, including bladder conditions, and therefore needs proper investigation before treatment is initiated.

Read: Doc, what causes bedwetting in teenagers and young adults?

“It mainly affects children but can continue into adolescence. Mental ill health is associated with the condition, including situations such as severe emotional trauma and stressful life events. The psychological impact of bedwetting on teenagers can escalate the mental distress,” says Dr Mwachonda, adding that it is not unusual for doctors to prescribe antidepressants to treat bedwetting.

By the age of five, 80-85 per cent of children achieve consistent nighttime dryness, according to Dr Njeri Karianjahi, Adolescent Medicine Physician at Aga Khan University Hospital.

“Nocturnal enuresis is defined as the involuntary loss of urine during sleep from the age of five and above and not due to a medical condition or substance effects. Research shows there is a global prevalence of nighttime bedwetting of 7.2 per cent among children and adolescents. From a medical perspective, bedwetting is closely tied to the gradual maturation of the nervous system and bladder function,” Dr Karianjahi says.

The ripple effect of bed wetting, she says, can be emotional distress, low self-esteem and social exclusion or bullying.

“Equally important is the emotional environment surrounding the adolescent. Minimising stress and avoiding punishment or shaming are essential. Adolescents facing enuresis are already at risk of embarrassment and reduced self-confidence, so supportive and compassionate care can make a significant difference in their overall well-being.”

Dr Karianjahi notes that bedwetting is not intentional, which is why it is not easy for those who experience it to stop.

“In infancy, urination is largely automatic, occurring as frequently as 15–20 times per day. As children grow, coordination between the brain, spinal cord, and bladder improves, allowing increasing control. Daytime bladder control typically develops first, often by around age two to four, with nighttime control following later. It is also not uncommon for bowel control to be established earlier than urinary control,” explains Dr Karianjahi.

Read: How to deal with adult bedwetting 

Jack Matika, an expert on children, youths and social development at Koinonia Community, says the environment plays a part in bed wetting past the age of five. For example, children living in an insecure environment, where they are always afraid of stepping out of the house, would rather do it on their beds. Also, homeless families struggle with this condition.

“If a street child is using drugs, wetting themselves can become normal. The challenge is that when these children leave the streets, return to their families and enrol in school, the problem may continue. If they are living with other children who do not wet the bed, it can become a source of psychological torture,” he tells Parenting, adding that most parents and caregivers do not seek medical intervention due to ignorance, at the expense of the child.

“Some youth or teens also still continue bed wetting because of some psychological torture they went through. If a child was abused at a young age, communication from the valve system to the brain gets difficult, so their bladder cannot control urine at night. Parents of such children should seek medical attention and psychological support,” says Matika.

He observes that teenage students in boarding schools use bedwetting to shame their schoolmates. “This can significantly break a child’s self-esteem,” he says.

Nurse Solomon Olale notes that prolonged absence of parents in their children’s lives due to work or other commitments also affects their children’s ability to develop skills like using the toilet.

“Children should be every parent’s priority. Have quality time with them at home and outside. Do not be too harsh; be involved and present, and they will always open up.”

Sammy Lenawalchingei, a counselling psychologist, encourages caregivers and parents to seek professional help for their children as soon as they can.

“With proper psychosocial support, the condition will not stop immediately, but they learn how they can stop it.”

Practical steps like limiting fluid intake in the late evening, encouraging the adolescent to empty their bladder before going to bed, and, where appropriate, gently waking them at night can support bladder training and reduce the likelihood of nighttime accidents.

“Management of enuresis is tailored to the individual adolescent and may involve a combination of behavioural strategies, supportive counselling, and, in some cases, medical therapy. These interventions are often guided by a paediatric nephrologist or specialist in kidney and urinary disorders. Treatment can take time and may not result in immediate or complete resolution,” concludes Dr Karianjahi.

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