Sickle Cell Disease and Enuresis

These instructions are for Children's Hospital of Philadelphia (CHOP) patients with sickle cell disease who experience enuresis, or bed-wetting.

Important information:

Enuresis is urinating when you do not intend to go. Enuresis is often called bed-wetting when it occurs at night. Enuresis is a common problem for children and teens with sickle cell disease. It happens because they are unable to concentrate their urine well and they are encouraged to drink a lot of liquids to prevent pain crisis. Bed-wetting is a symptom of sickle cell disease; your child is not lazy and does not do this on purpose. They should not be punished as it is beyond their control.

Symptoms of enuresis include urinating (peeing) more during the day or wetting the bed at night.

Enuresis may cause embarrassment for the child wetting the bed. Parents may also become angry or frustrated at having to do laundry more often, the smell or the expense of replacing the mattress.

Patient instructions for enuresis:

Not all strategies work for all children so it is best to experiment with what works best for your family.

• Set an alarm and have your child to use the bathroom during the night.

• Have the last adult who goes to bed wake up the child one more time to use the bathroom.

• Urinate every 2-3 hours during the day and always before going to bed.

• Drink more liquids during the day and limit fluid intake in the hours before bed.

• Avoiding liquids that contain caffeine like soda, tea and coffee.

• Constipation can worsen enuresis. Make sure your child has a soft bowel movement daily. Stool softeners may be helpful if needed. If your child has not had a bowel movement by dinnertime each day, they should sit on the toilet for 10 minutes after dinner and try.

• Use a washable, reusable bed pad for easier cleaning and mattress protection.

• Involve your child in the process of stripping the bed, doing the laundry and making the bed (if age appropriate).

• Schedule an appointment with a urologist for further evaluation. They may prescribe a bedwetting alarm system or a medicine.

Contact your CHOP hematology team with questions or concerns.

Division of Hematology

215-590-3535

Sickle Cell Center

For non-urgent issues, send your team a message in the MyCHOP portal.

Reviewed on June 22, 2023, by Alexandra Kaspin, RN, MSN