Parents or guardians of children who experience bedwetting at night or accidents during the day should treat this problem with understanding and patience. This loss of urinary control is called urinary incontinence or just incontinence.
Although it affects many young people, it usually disappears naturally over time, which suggests that incontinence, for some people, may be a normal part of growing up. Incontinence at the normal age of toilet training may cause great distress.
Daytime or nighttime incontinence can be embarrassing. It is important to understand that many children experience occasional incontinence and that treatment is available for most children who have difficulty controlling their bladders.
Urinary incontinence (UI) is any involuntary leakage of urine (pee). It is a common problem and can be very distressing. In almost all cases it is the result of another underlying medical condition which can be treated.
What causes urinary incontinence?
Urinary incontinence can occur in people of all ages and is caused by many different things. These include:
Congenital (present at birth) structural problems which are usually diagnosed in childhood, such as an ectopic ureter (where the ureter – the tube that carries urine from the kidney to the bladder – bypasses the bladder and terminates elsewhere), posterior urethral valves (a blockage in the urethra – the tube that carries urine outside the body) and the more severe bladder exstrophy-epispadias complex (where the bladder is open and exposed on the outside of the abdomen).
Disorders which can interfere with nerve function of the bladder. These include spina bifida, multiple sclerosis, strokes and spinal cord injury.
An overactive bladder disorder can cause functional urinary incontinence (day and nighttime incontinence).
Being in a deep sleep or lack of bladder control can cause episodic urinary incontinence – such as bedwetting – in young children.
The consumption of caffeine or cola drinks which stimulate the bladder.
Polyuria: a condition which causes a person to produce too much urine. This condition is usually the result of another condition such as diabetes or a significant kidney function impairment.
What are the signs and symptoms of urinary incontinence?
A child will be unable to control when they go to the toilet. They may feel like they need to pass urine and, unable to delay its release, will urinate very quickly after. This is known as urge incontinence.
Occasionally, they may also leak urine when the bladder is put under sudden pressure, for example when they cough, sneeze or laugh. This is called stress incontinence.
Urinary incontinence can be very distressing for a child. They can lose confidence, may feel socially excluded and in some cases, might be bullied because of their condition. They may even find it difficult to function normally in everyday life.
Many fail to report the problem to their parents or doctor out of embarrassment. However, it is an extremely common problem which can be successfully treated.
How is urinary incontinence normally diagnosed?
Don’t be embarrassed to seek help for this problem. If the child has a problem with incontinence, talk to their doctor straight away.
They can organise an appointment with a specialist who can help you get to the bottom of this annoying and distressing condition.
How is urinary incontinence normally treated?
The treatment the child will receive for urinary incontinence will depend on the type of incontinence they have and the severity of their symptoms.
If their incontinence is caused by an underlying condition, such as a duplex kidney with an ectopic ureter they will receive treatment for this first.
Conservative treatments, which do not involve medication or surgery, include:
- Lifestyle changes – drinking fewer fizzy drinks, creating a routine for using the toilet, treating constipation and losing weight.
- Pelvic floor muscle training – which involves tensing and relaxing the muscles of the pelvis.
- Bladder training – which involves learning techniques to increase the length of time between feeling the need to urinate and passing urine.
- Medication or surgery may be necessary depending on the cause of the incontinence.
There are a number of different medicines you can take to help with incontinence and have possible side effects.
Common side effects to medications for urinary incontinence include:
- feeling nauseous or being sick
- indigestion or tummy pain
- constipation / diarrhoea
- hot flushes
- dry mouth
If all other treatments are unsuccessful, surgery may be recommended. There are lots of different surgical procedures which can help with urinary incontinence.
The type of surgery the child is offered will depend on their medical history and details of their problem.
Before making any decisions, you can discuss the risks and benefits of surgery with the child’s specialist, as well as any possible alternative treatments.
- Incontinence is also called enuresis
- Primary enuresis is wetting in a person who has never been dry for at least 6 months.
- Secondary enuresis is wetting that begins after at least 6 months of dryness.
- Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime incontinence.
- Diurnal enuresis is wetting when awake, also called daytime incontinence.
Points to Remember
- Urinary incontinence in children is common.
- Nighttime wetting occurs more commonly in boys.
- Daytime wetting is more common in girls.
- After age 5, incontinence disappears naturally at a rate of 15 percent of cases per year.
- Treatments include waiting, dietary modification, moisture alarms, medications, and bladder training.