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Firstly I must state that I am not medically trained and do not profess to have any medical knowledge, first and foremost if you feel your child has a medical problem you should consult a doctor.

ALL THE INFORMATION ON THIS PAGE HAS BEEN TAKEN FROM OTHER PAGES I HAVE FOUND. EACH PIECE OF INFORMATION IS CREDITED WITH A LINK BACK TO THE PAGE OF ORIGIN.

Daytime wetting affects about 1 in 75 children over the age of 5 (about 125,000 children aged 5 to 16 in the UK). More of these are girls than boys.

It helps to keep a record chart of each day. Break the day up into chunks say MORNING BREAK - LUNCHTIME - TEATIME - BEDTIME and check pants at each of those times to keep a record of wet and or dry periods, this will help the doctor when you consult him.
(ERIC - Enuresis Resource and Information Centre)

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 voiding habits, the most common being infrequent voiding.

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 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. Additionally, these children often develop urinary tract infections (UTIs), leading to an irritable or overactive bladder.

Other Causes

Some of the same factors that contribute to nighttime incontinence mayact together with infrequent voiding to produce daytime incontinence. These factors include

  • A small bladder capacity
  • Structural problems
  • Anxiety-causing events
  • Pressure from a hard bowel movement (constipation)
  • Ingestion of bladder irritants such as caffeine and aspartame (an artificial sweetener).

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 (incomplete emptying) sets the stage for urinary tract infections.

What Treats or Cures Incontinence?

 Growth and Development

Most urinary incontinence fades away naturally. Here are examples of what can happen over time:

  • Bladder capacity increases.
  • Natural body alarms become activated.
  • An overactive bladder settles down.
  • Production of ADH becomes normal.
  • The child learns to respond to the body's signal that it is time to void.
  • Stressful events or periods pass.

Many children overcome incontinence naturally (without treatment) as they grow older. The number of cases of incontinence goes down by 15 percent for each year after the age of 5.

http://www.niddk.nih.gov/health/urolog/pubs/uichild/uichild.htm#whatcausesd

Diurnal Enuresis
Daytime Wetting in "Normal" Children

Your normal school age child has long been potty trained but he or she continues to wet his/her pants. Repeated trips to the doctor find no obvious physical problem. You have a behavior problem, right? DON'T BE SO SURE. Many a child who has long mastered the basics continues to have accidents, or leakage - Diurnal enuresis. Many will show no gross medical problem. We have seen medical articles that believe that 'at least 1% of healthy children have chronic daytime incontinence after' five years of age. That is a significant number. Unfortunately most articles deal with this problem only as a side note.

Daytime problems are harder for everyone involved. Even parents who accept that bedwetting is not the child's fault often believe that wet pants during the day are at best a sign of carelessness and at worst a deliberate act of defiance.

We feel that many of these problems have a physical cause and while some are "functional" very few are behavioral. Problems have many causes including stress, emotional trauma, too lax training, too rigid training, developmental delays, bladder infections, a small bladder, an over active bladder, and many more. All the problems that can cause bedwetting also often cause daytime wetting. In fact many bedwetters also have problems with daytime control as well.

It is interesting that the Kegel exercises that are used to help women with stress incontinence are now being successfully used to help wet children better master their bladders.

A common daytime problem for children is a form of urge incontinence where the child will leak a small to medium amount of urine. Giggle incontinence is where wetting is triggered by laughter. We have recently been sent information on a new treatment for giggle incontinence .

Another type of daytime wetting problem is called dysfunctional voiding. It is seen mostly in preschool and early school age girls. This problem is one that often affects children who are fully trained. Many of these children hold their urine well for long periods. Too well as it turns out.

The problem is that intricate interaction of the various muscles involved in voiding is scrambled. Normally when the bladder is nearly full, it begins to contract. This is what causes a person to feel the urge to go. To urinate you cause the bladder to contract while simultaneously relaxing the muscles of the lower abdomen and the bladder's sphincter. The sphincter opens and bladder empties completely. Only then does the sphincter close.

In a child with dysfunctional voiding, the sphincter may involuntarily clamp shut during urination. It may never properly open at all. This leads to urine remaining in the bladder. This can lead to bladder infections. This starts a vicious cycle, the bladder contracting more and more strongly trying to empty as the sphincter locks closed. The result is not only retained urine but sudden unpredictable pants wetting. Children with the problem often have chronic bladder infections. These infections can do damage to the bladder wall, complicating the problem. Infections can spread to the kidneys. Kindney infections can be life threatening.

While we have seen mention of this problem for ten years, information on it is rare. Information on the Web has been nearly nonexistent. We have found a link that discusses the treatment of dysfunctional voiding used by doctors.

(It is interesting that the doctor quoted in this link claims that dysfunctional voiding is more common than bedwetting. We have never heard a claim of this magnitude before.)

Tri-State Incontinence Support
http://idt.net/~tis/child.html

I hope some of this information helps, please visit the websites for more information. See also our LINKS page for more useful links.

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