Daytime Wetting (Urinary Incontinence) in Children
What is daytime wetting?
Daytime wetting, or urinary incontinence, is a condition in which a child will pass urine unexpectedly during the day after potty training.
Who is affected by daytime wetting?
Daytime wetting affects approximately 1 in 10 children. Generally, children who have been potty-trained and are age 5 and older are affected by daytime wetting.
Who is at risk for developing daytime wetting?
Any child is at risk for experiencing daytime wetting, however, the condition is more common in girls than boys.
Symptoms and Causes
What causes daytime wetting?
Daytime wetting can be caused by any of the following:
- The child ignores the urge to urinate. As a result, the bladder becomes too full, causing urine leakage.
- The child has an overactive (frequently squeezes) bladder and cannot get to the toilet in time.
- The child has an underactive bladder and does not have the urge to use the bathroom.
- The child may be suffering from dysfunctional elimination syndrome, in which the bladder muscles and nerves are not working together. The muscles may tighten, stopping the flow of urine when there is still urine in the bladder.
- Some neurologic and developmental conditions can cause poor bladder control.
- The child is suffering from constipation and the full bowel is pressing on the bladder.
- The child is suffering from a urinary tract infection.
Children are often mistakenly blamed for being lazy or seeking attention when they have daytime wetting episodes. However, this is not usually the case and other causes should be explored.
What are behaviors associated with daytime wetting?
- Urinary urgency: An immediate need to go to the bathroom
- Urinary frequency: Urinates more than 8 times a day.
- Urinary infrequency: Urinates fewer than 3 times a day.
- Incomplete bladder emptying: Does not completely empty the bladder when urinating.
- Holding behaviors: Squatting or squirming, to avoid accidents.
Diagnosis and Tests
How is daytime wetting evaluated?
The provider will do a physical exam and obtain family and medical history. The provider will also ask the parents how often the child is dry, when wetting happens, how often it happens, and any other symptoms the family notices.
Additional tests to evaluate daytime wetting may include:
- X-rays of the abdomen
- Ultrasound to view the kidneys and bladder
- Urine tests
- Examination of spine and bladder opening
- Abdominal examination
Management and Treatment
How is daytime wetting treated?
Daytime wetting can often be treated by first determining if there is a medical problem, such as constipation, diabetes or a urinary tract infection. The provider will also review dietary and behavior changes.
When should I call the provider about daytime wetting?
By age 5, children typically have the ability to stay dry throughout the day. Call your provider about daytime wetting if the following occur:
- Possible signs of a bladder infection such as pain with urination, accompanied by strong urine odor.
- The child has a weak urine stream, trickles, or sprays urine
- The child was staying dry all day, then started to have daytime wetting.
- The child appears not to sense when he or she needs to urinate.