What is urinary incontinence?

Urinary incontinence refers to the leakage of urine. It can be extremely frustrating and embarrassing for families and children. Each year, we treat more than 1,000 children for urinary incontinence.

The different types of incontinence include:

• Urge incontinence: Characterized by frequent and urgent trips to the bathroom associated with attempts to hold the urine, such as crossing legs, squatting and dancing to prevent leakage.
• Dysfunctional voiding: As the bladder empties, children with dysfunctional voiding tighten their pelvic floor muscles and may cut off the urine stream before completely emptying their bladder. They may leave a large amount of urine in their bladder that leaks after voiding.
• Underactive bladder: Children with underactive bladder tend to postpone voiding and only empty a few times a day with little urge to do so.
• Giggle incontinence: Children with giggle incontinence wet ONLY when laughing. Once they start urinating they are unable to stop the flow of urine and usually soak their clothes.
• Vaginal voiding: Girls with vaginal voiding trap a small amount of urine in the vagina that dribbles out after voiding.

Causes

There are many reasons why children wet:

• Many children do not want to stop fun activities to go to the bathroom.
• Some children urinate only two to three times a day — they simply are too busy to go to the bathroom until it’s too late to make it to a toilet in time.
• Other children have uncontrolled bladder contractions that make them feel like they need to go to the bathroom “right now!”
• Some children do not fully empty their bladder when they do go to the bathroom, leaving residual urine behind.

Children generally do not wet out of laziness, emotional problems or inappropriate toilet training. Physical causes of wetting are rare.

Treatment

Our DOVE Center is devoted to the treatment and management of children who have urinary incontinence. Our team will work with you and your child to help understand why your child wets, and recommend a treatment plan.

Steps involved in getting your child dry may include:

• Urinating on a routine schedule of every two to three hours.
• Treating any underlying constipation.
• Increasing the amount of water consumed during the day.
• Avoiding drinks that irritate the bladder: caffeine, carbonation (fizz/bubbles), citrus juices and sports drinks.
• Proper positioning on the toilet.
• Biofeedback training: A way to teach children how to relax their pelvic floor muscles so they can empty their bladder fully.
• Behavior modification: Our psychologist can work with your child to provide education as to how the body works and why children need to follow the recommendations given. The psychologist will also discuss behavior management around toileting.
• Medications can be used in children with an overactive bladder.

Voiding Calendars

Reviewed by: Division of Urology
Date: January 2014