We've had a lot of bed wetting problem here, too. It sounds like you're doing pretty good on the physical part of it. We didn't start making progress until we realized that the bed wetting was sometimes a choice. The kid's bathroom was intimidating to them, and they preferred to go through the hassle of wetting their beds over facing a scary bathroom. The toilet is right by the windows, with close walls on three sides. It's one of the coldest rooms in the house and doesn't get good light in that corner. Flushing the toilet is even worse! It makes that horrible noise in the middle of an otherwise very quiet night, and they just couldn't handle it. When they did get up in the night, they would go in the garbage can, the floor vents, baskets of laundry, the bathtub, etc. It was not a happy time.

We changed the setting and nighttime bathroom rules, and it's made a really big difference. We got some all-white Christmas icicle lights to put up around the ceiling as nightlights, and added extra rugs/bathmats to the floor that they all really liked. We have a small light now in part of the bathroom that is never turned off, and have far more flashlights than is reasonable for a family of 6. No one has to flush the toilet overnight anymore, either. The kids picked out some fun curtains for the windows right next to the toilet, which also makes it less scary. They're also allowed to leave the door to the bathroom open at night (a no-no during the day), so they don't feel all alone. If all else fails, they have permission to use the bathtub. At least it's contained and has working plumbing!

Maybe you can make it part of his routine to change his own bedding and do his own overnight laundry each morning. Make sure he knows that it's just a daily thing that needs to be done - not a punishment. Buying sheets, blankets, pillows or pajamas they especially love can be a good motivator, too.

Last thing I can think of (as an interim tool) are things that will just help to protect his bed. If you can locate a medical supply store anywhere near you, pick up some Chucks (an absorbent pad about 2' x 2') or some pull-up style underpants meant for teens or adults. If you strip the bedding off of his bed and just use a sleeping bag for a while, it will also cut down on the laundry pile every morning for a while. Good luck, and welcome to MAT!

I understand that some are opposed to medication but what the doctor told us was that by this age, there should be a developed hormone that helps control the bladder at night. We opted for medication in the teens to control it and it it was a success almost immediately. This was our last resort of course.