Urinary Incontinence in Children (cont.)
What causes daytime incontinence?
Daytime incontinence that is not associated
with urinary infection or anatomic abnormalities is less common than nighttime
incontinence and tends to disappear much earlier than the nighttime versions.
One possible cause of daytime incontinence is an overactive bladder. Many
children with daytime incontinence have abnormal elimination habits, the most
common being infrequent voiding and constipation.
An Overactive Bladder
Muscles surrounding the urethra—the tube that takes
urine away from the bladder—have the job of keeping the passage closed,
preventing urine from passing out of the body. If the bladder contracts strongly
and without warning, the muscles surrounding the urethra may not be able to keep
urine from passing. This often happens as a consequence of urinary tract
infection (UTI) and is more common in girls.
Infrequent Voiding
Infrequent voiding refers to a child's voluntarily holding
urine for prolonged intervals. For example, a child may not want to use the
toilets at school or may not want to interrupt enjoyable activities, so he or
she ignores the body's signal of a full bladder. In these cases, the bladder can
overfill and leak urine. In addition, these children often develop UTIs, leading
to an irritable or overactive bladder.
Other Causes
Some of the same factors that contribute to nighttime
incontinence may act together with infrequent voiding to produce daytime
incontinence. These factors include
- small bladder capacity
- structural problems
- anxiety-causing events
- pressure from a hard bowel movement (constipation)
- drinks or foods that contain caffeine, which increases urine output and may
also cause spasms of the bladder muscle, or other ingredients to which the child
may have an allergic reaction, such as chocolate or artificial coloring
Sometimes overly strenuous toilet training may make the child unable to relax
the sphincter and the pelvic floor to completely empty the bladder. Retaining
urine, or incomplete emptying, sets the stage for UTIs.
Next: What treats or cures incontinence in children? »
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