Urinary incontinence in children is a condition commonly observed in the pediatric patient group that can affect both the quality of life of children and the daily life of families. While it may be related to developmental processes, in some cases, it may arise as a symptom of underlying physiological, anatomical, and psychological factors. Urinary incontinence complaints occurring during night and daytime should be evaluated in detail according to the child's age and general health condition.
What is Urinary Incontinence in Children?
Urinary incontinence in children is the condition where the child cannot control urination involuntarily. Occasional bedwetting in children under 5 years of age may be considered a natural part of development. However, if it persists frequently and recurrently beyond this age, it requires medical evaluation.
Urinary incontinence is generally categorized into two types:
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Nocturnal enuresis (nighttime bedwetting)
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Diurnal enuresis (daytime bedwetting)
What are the Causes of Urinary Incontinence in Children?
Urinary incontinence problem in children can be caused by an underlying health issue or can be due to emotional, psychological, and behavioral reasons.
Physiological Causes
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Small bladder capacity relative to the child's age
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Underdeveloped reflex to wake up with the sensation of urination during sleep
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Genetic predisposition
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Excessive fatigue
Functional Causes
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Underdeveloped toilet habits
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Behavior of postponing toilet visits
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Irregular fluid consumption
Medical Causes
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Urinary tract infections
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Constipation
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Neurological diseases
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Sleep apnea
Psychological Causes
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Traumatic experiences such as moving, divorce, birth of a sibling
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School anxiety, self-confidence problems
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Attention Deficit and Hyperactivity Disorder (ADHD)
Nocturnal Enuresis in Children
Nocturnal enuresis, medically termed enuresis nocturna, is a condition mostly seen in children over 5 years old where bedwetting occurs during sleep at night.
Enuresis nocturna can adversely affect the child's physiological, psychological, and social development.
It is a treatable condition, and family support is crucial during the child’s treatment process. Parents being patient and understanding will help the child cope with this issue.
Some causes of nighttime bedwetting include:
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Genetic factors
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Inadequate increase in antidiuretic hormone (ADH) levels at night
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Underdeveloped bladder muscles
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Sleep pattern disorders
Nighttime bedwetting generally decreases and disappears over time; however, frequent and prolonged cases may require evaluation.
Diurnal Enuresis in Children
Daytime urinary incontinence is often associated with incorrect toilet habits or behavioral factors. However, it should be considered more carefully than nighttime bedwetting as there may be an underlying medical problem.
Causes of daytime wetting include:
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Habit of postponing going to the toilet
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Insufficient fluid intake or excessive fluid consumption
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Weak bladder muscles
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Emotional stress and attention deficit
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Constipation
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Urinary tract infections
A detailed evaluation, physical examination, and urine test, if necessary, are recommended for children with daytime urinary incontinence.
What are the Treatment Options for Urinary Incontinence in Children?
In cases of urinary incontinence, the first step usually involves making changes in daily routines. While implementing these changes, it's crucial to avoid pressuring the child, displaying overly meticulous behaviors, and using scolding approaches.
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Adjusting the amount of fluids consumed during the day and at night,
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Avoiding water intake before sleeping,
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Avoiding foods and drinks containing caffeine,
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Going to the toilet before sleep,
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Waking the child at intervals during the night to use the toilet,
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Staying away from carbonated drinks and sugary foods,
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Ensuring the toilet used by the child has a seat and using a step stool suitable for their height,
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Your doctor may also suggest behavioral changes aimed at enhancing the child's self-esteem.
In some cases, alarm therapy or medication treatment may be initiated for children. Alarm therapy should be considered for children above 8 years, may last 2-3 months, and can provide a 70-84% improvement.
Medication treatment is used to prevent unwanted bladder contractions and its side effects may include dry mouth, blurred vision, and facial flushing. If the urinary incontinence problem is due to constipation or infection, these causes need to be treated first.
Your child may benefit from therapy techniques to cope with changes or other stress factors in their life. Working with a child psychiatrist can play a significant role in this process.
Frequently Asked Questions
Is daytime bedwetting in children more serious than nighttime?
Yes, daytime urinary incontinence can sometimes indicate infections, neurological issues, or behavioral disorders and should be handled more carefully.
Can an absence of toilet training cause urinary incontinence?
Yes. Behaviors such as postponing urination, irregular bowel movements, or incorrect toilet training can negatively affect bladder control.
Can bedwetting in children be psychological?
Yes. Factors such as changes within the family, stress, fears, or school anxiety can trigger bedwetting.
Does every bedwetting case require treatment?
No. Some cases observed until the age of 5 may be temporary. However, if it continues regularly after the age of 5, it should definitely be evaluated by a specialist.