Urinary Incontinence in Children
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.
How does the urinary system work?
Urination, or voiding, is a complex
activity. The bladder is a balloon-like organ that lies in the lowest part of
the abdomen. The bladder stores urine, then releases it through the urethra, the
canal that carries urine to the outside of the body. Controlling this activity
involves nerves, muscles, the spinal cord, and the brain.
The bladder is composed of two types of muscles: the detrusor, a muscular sac
that stores urine and squeezes to empty; and the sphincter, a circular group of
muscles at the bottom or neck of the bladder that automatically stay contracted
to hold the urine in and automatically relax when the detrusor contracts to let
the urine into the urethra. A third group of muscles below the bladder (pelvic
floor muscles) can contract to keep urine back.
A baby's bladder fills to a set point, then automatically contracts and
empties. As the child gets older, the nervous system matures. The child's brain
begins to get messages from the filling bladder and begins to send messages to
the bladder to keep it from automatically emptying until the child decides it is
the time and place to void.
Incontinence happens less often after age 5: About 10 percent of 5-year-olds,
5 percent of 10-year-olds, and 1 percent of 18-year-olds experience episodes of
incontinence. It is twice as common in boys as in girls.
Failures in this control mechanism result in incontinence. Reasons for this
failure range from simple to complex.
Next: What causes nighttime incontinence in children? »
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