Enuresis (involuntary peeing that is abnormal for a child’s age) is one of the most common types of voiding dysfunction, and includes both nighttime wetting (nocturnal enuresis) and daytime wetting (diurnal enuresis).
Children often exhibit posturing behaviors, (pee-pee dance, cross their legs, squat). Although it is normal for very young children to do this as they are learning to toilet train, sometimes these symptoms can continue even as the child grows older.
Voiding dysfunction may cause a child to run to the bathroom frequently. Children may have to urinate every 10-30 minutes or in less severe cases, every 1-3 hours. They will often urinate small volumes or feel the urge to urinate again soon after voiding.
What causes voiding dysfunction?
The bladder is a muscle that stores urine, and it empties by contracting the muscle. A normally functioning bladder only contracts when it is at full capacity (the normal amount of urine that it can hold comfortably) and it is time to void.
When the bladder is irritable or overactive, it tends to contract at will, regardless of how much urine it is holding. It’s important for you to know that what your child is feeling is real and they do not have conscious control over it.
Constipation often contributes to these symptoms of voiding dysfunction. Your child may have mild to moderate constipation without complaining and the rectum and colon can stretch to accommodate the stool. This causes pushing on the bladder resulting in urgency/frequency, a decrease in capacity, and incomplete emptying.
How is voiding dysfunction diagnosed and treated?
In diagnosing overactive bladder, your Nemours pediatric urology team will do few things to rule out infection, or any serious, but rare, disorder:
thorough health history
urinalysis and urine culture
renal and bladder ultrasound to check for bladder and kidney abnormalities
urine flow study (which uses a special toilet to measure your child’s voiding pattern)
post void residual (similar to the ultrasound, this is done after voiding to make sure your child is able to empty his or her bladder completely)
We will also ask you to keep a Voiding/Bowel Diary (PDF). This diary provides invaluable information that helps our Nemours pediatric urologists assess your child’s exact voiding problem. It will tell us how frequently your child is voiding, how much their bladder is letting them hold, if there is wetting and when this wetting occurs in relation to voiding. It will also allow us to better assess their stooling pattern and assure there is no constipation.
Most children will outgrow the symptoms of overactive bladder on their own without intervention, if there is no abnormality present. Your Nemours urologist may recommend some medications to relax the bladder depending on your preference and the age of your child.
Addressing your child’s symptoms of overactive bladder and wetting can dramatically improve your child’s quality of life. We often see children’s nighttime bedwetting improve after their daytime symptoms are addressed.
Bedwetting is when kids who are old enough to control their bladder pee at night during sleep. It's a common problem in kids, especially those under 6 years old.
Why Does Bedwetting Happen?
Doctors don't know for sure what causes bedwetting or why it stops. But it's often a natural part of development, and kids usually grow out of it. It's most common in young kids, but can last into the teen years. Most of the time, bedwetting is not a sign of any deeper medical or emotional issues.
Bedwetting often runs in families: many kids who wet the bed have a relative who did too. If both parents wet the bed when they were young, it's very likely that their child will.
How Can We Cope With Bedwetting?
Bedwetting is an issue that millions of families face every night, and can be very stressful. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.
Bedwetting usually goes away on its own, but may last for a while. It can be embarrassing and uncomfortable for your child, so it's important to provide emotional support until it stops.
Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about any other family members who struggled with it when they were young.
Try to have your child drink more fluids during the daytime hours and less at night (and avoid caffeine-containing drinks). Then remind your child to go to the bathroom one final time before bedtime. Many parents find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.
When your child wakes with wet sheets, don't yell or punish. Have your child help you change the sheets. Explain that this isn't punishment, but it is part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.
When Should I Call the Doctor?
Bedwetting that begins suddenly or happens with other symptoms can be a sign of another medical condition, so talk with your doctor.
suddenly starts wetting the bed after being consistently dry for at least 6 months
begins to wet his or her pants during the day
snores at night
complains of a burning sensation or pain when urinating
has to pee often
is drinking or eating much more than usual
has swelling of the feet or ankles
is 7 years of age or older and still wetting the bed
Also let the doctor know if your child is under a lot of stress, if you're feeling frustrated with the situation, or if you could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about and overcome the bedwetting.
Remember, the long-term outlook is excellent and in almost all cases, dry days are just ahead.
Reviewed by: Marcella A. Escoto, DO
Date reviewed: April 28, 2017