These devices might be helpful for a child with enuresis who is eight or older (or in younger bed wetters if they are highly motivated) and who has not succeeded with other methods. Unlike the older pad-and-bell systems, the newer alarms are compact, portable, simple to use, and relatively inexpensive (about $45 to $60). (Beware of aggressively advertised, expensive programs that promise to “cure” bed-wetting. Helping your child accomplish this goal may be labor-intensive, but it shouldn’t be expensive.) A sensor attached to the child’s underwear will cause the device to buzz or vibrate against the skin like a pager when very small amounts of urine are released.
The child should be encouraged to wake up as quickly as possible when the alarm goes off, get to the toilet, and empty any remaining urine. Over a period of several weeks, most children begin to associate the bladder with the alarm-awakening process, and then with awakening before the alarm goes off. Medical studies have demonstrated an overall success rate of about 70 percent of cases in which these alarm systems are used; they are most effective when both parent and child are motivated to use them every night for two to three months Difficulties may arise if the child does not readily awaken to the noise or vibration. Parents should be prepared to get up when the alarm sounds, gently rouse the child, and have him turn off the alarm and use the toilet after he is definitely awake. Patience and persistence on everyone’s part will be needed to condition the child’s central nervous system to awaken first to the alarm and eventually to the full bladder.
For those who want to try a less high-tech approach, a regular alarm (bell, buzzer, or radio) can be set to go off three or four hours after the child goes to bed. The alarm should be out of his reach so he must get up to turn it off. He should be encouraged to proceed from alarm to toilet to empty his bladder before returning to bed. The timing of this wake-up call will have to be determined by trial and error, of course, and will depend upon the hour that bed-wetting most commonly takes place. As with the bed-wetting alarms, this approach will require more effort if the child is extremely difficult to awaken during the night.