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- Patient Comments: Urinary Incontinence in Children - Nighttime
- Patient Comments: Urinary Incontinence in Children - Daytime
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- Urinary incontinence in children facts
- What is urinary incontinence?
- How does the urinary system work?
- What are the different types of urinary incontinence in children?
- How common is urinary incontinence in children?
- What causes nighttime incontinence in children?
- What causes daytime incontinence in children?
- How do you differentiate between organic and nonorganic causes of urinary incontinence?
- What is the treatment for urinary incontinence in children?
- What is the prognosis of urinary incontinence in children?
- Where can people get more information on urinary incontinence in children?
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What causes daytime incontinence in children?
Common causes of daytime wetting include voluntary holding of urine, urinary tract infection, constipation, and wetting with giggling. Girls are more commonly affected than boys. Less common causes include more serious issues such as neurological causes (neurogenic bladder), urinary tract anatomic abnormalities, and diabetes. Voluntary holding of urine is the most common cause of daytime wetting in young children. This is often observed in 3- to 5-year-olds who don't want to take the time to use the toilet. They are just too busy to take a break and will often fidget, squirm, and hold on to their perineal areas. Most children grow out of this on their own as they get older.
How do you differentiate between organic and nonorganic causes of urinary incontinence?
It is important to recognize that most cases of urinary incontinence are caused by nonorganic problems, but since there are organic causes, physicians may evaluate affected children with some basic studies. Evaluation always begins with a complete history and physical exam. This differentiates between the otherwise healthy child and the child with underlying disease. The clinician will probably ask about psychological stressors, such as starting a new school, the birth of a sibling, or parental strife. In addition, in order to evaluate the severity of the symptoms, parents will be encouraged to keep a voiding diary. These are diaries which document the number of daytime voids, volumes, timing, and relationship with eating and drinking. In addition, these diaries should document the frequency of daytime wetting or nighttime wetting. Besides the history, physical, and diary, a urinalysis can be helpful to screen for organic causes, such as diabetes and urinary tract infections. For children with significant daytime symptoms, ultrasound imaging of the urinary tract including bladder and kidneys may be needed to evaluate for anatomic abnormalities. Lastly and rarely, if a neurological cause is suspected, an MRI of the spine may be indicated to evaluate for spinal cord abnormalities.