Never punish and appreciate that you may be dealing with a child with poor self esteem. Behavioral modification- keep a calendar of dry and wet nights and give stars or other small reward for dry nights. Bring chart to office on the next visit. Encourage the child. Have the child phone you and relate how they are doing.
Compliance is a problem and staying on the alarm a problem.
Alarm that hooks on to undergarment work well. Medications Ditropan- successful if bladder function or sphincter problem. Useful for special occasions and for desperate families. Treat UTI if urine culture is positive. Reference Hurley, R. Morrison.