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Urinary incontinence is when a child loses bladder control, causing urinary accidents. It can range from minor leakage to completely emptying the bladder. Children can experience daytime incontinence, nighttime incontinence or both.
There are also other variations of childhood incontinence. They include:
- Urge incontinence, characterized by urgent and frequent trips to the bathroom, often not making it in time
- Underactive bladder, when children empty their bladder only a few times a day, and tend to postpone emptying their bladder with little urge to do so
- Giggle incontinence, when children start urinating when they laugh and are unable to stop the flow
- Vaginal voiding, when girls trap a small amount of urine in the vagina that dribbles out after they use the bathroom
Children become toilet-trained at a range of ages. However, many children have few wetting episodes after age five. Episodes of incontinence happen in about:
- 10% of 5-year-olds
- 5% of 10-year-olds
- 1% of 18-year-olds
- Boys are twice as likely to experience it as girls.
There are many reasons for childhood incontinence. Causes of daytime incontinence include:
- Urinary tract infections
- Other urinary tract problems
- Overactive bladder
- Underactive bladder
- Incomplete bladder voiding
Some children do not want to stop fun activities to go to the bathroom (infrequent voiders) or have uncontrolled bladder contractions that make them feel like they need to go to the bathroom immediately. Daytime incontinence is less common than nighttime incontinence and tends to resolve itself at an earlier age than nighttime incontinence.
Some children have constipation (not having soft bowel movements 1-2 times a day). This puts pressure on the bladder, which can prevent the bladder from filling and emptying as well, or cause incontinence.
The most common causes for nighttime incontinence include:
- Slower physical development
- An overproduction of urine at night
- The child's inability to recognize his or her bladder filling when asleep
Nighttime incontinence has also been linked to attention deficit hyperactivity disorder and anxiety. Sometimes there is a family history of nighttime bedwetting, suggesting a hereditary factor.
Wetting in younger children is common and not considered incontinence. For that reason, daytime incontinence is not usually diagnosed until age five or six, and nighttime incontinence is not usually diagnosed until age seven.
Most childhood incontinence fades away naturally as a child grows, and does not require treatment. When needed, treatment may include:
- Bladder training – including exercises to strengthen the bladder muscles for better urination control
- Having the child avoid drinks with caffeine, carbonation, citrus or chocolate
- Having the child urinate on a set schedule
- Avoiding constipation
Other options include moisture alarms for nighttime incontinence and, sometimes, medication.
Almost all children who have urinary incontinence outgrow it by the time they are teenagers. Fewer than 1% continue to have problems into adulthood.
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If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices.