urinary incontinence in children
children s health issues
Urinary Incontinence in Children
The pattern of incontinence helps the doctor determine the likely cause. If the child has never had a consistent dry period during the day, the doctor may consider the possibility of a birth defect, an anatomic abnormality, or certain behaviors that can lead to incontinence. Several uncommon but important disorders affect the normal anatomy or function of the bladder, which can lead to urinary incontinence. For example, a spinal cord defect such as Neural Tube Defects and Spina Bifida can cause abnormal nerve function to the bladder and lead to incontinence. Some infants have a birth defect that prevents the bladder or urethra from developing completely, leading to nearly constant urine loss (total incontinence). Another type of birth defect causes the tubes that connect the kidneys to the bladder (ureters) to end in an abnormal location in the bladder or even outside the bladder (such as in the vagina or urethra or on the surface of the body), causing incontinence (see Certain behaviors can lead to daytime incontinence, especially in girls. Such behaviors include urinating infrequently and urinating using an incorrect position (with legs too close together). With such positions, urine can accumulate in the vagina during urination, then dribble out after standing. Some girls have bladder spasms when laughing, resulting in “giggle incontinence.” If the child has been dry for a long time and the incontinence is new, the doctor considers conditions that can cause loss of continence. These include constipation, infections, diet, emotional stress, and sexual abuse. Some medical conditions that the child develops can cause new urinary incontinence. Constipation in Children , which is defined as difficult, hard, or infrequent stooling, is the most common cause of sudden changes in urinary continence in children. Bacterial Urinary Tract Infection (UTI) in Children (UTIs) and viral infections causing bladder irritation (bacterial or viral To prevent urine from leaking, many children with incontinence learn to cross their legs or use other positions (holding maneuvers), such as squatting (sometimes with their hand or heel pressed between their legs). These holding maneuvers may increase the chance of developing a urinary tract infection. Sexually active adolescents can have urinary difficulties caused by certain Overview of Sexually Transmitted Infections (STIs) . Dietary causes includecaffeineand acidic juices, such as orange and tomato juice, which can irritate the bladder and lead to leakage of urine. Stressful events such as Divorce and Children or separation of the parents, moving, or Children who are Sexual abuse may develop urinary incontinence. Children with Diabetes Mellitus (DM) in Children and Adolescents , Causes of urinary incontinence vary depending on whether incontinence occurs in the daytime or mainly at night. Innighttime incontinence (enuresis, or bed-wetting),most cases do not involve a medical disorder but result from a combination of factors, including Developmental delay Uncompleted toilet training A bladder that contracts before it is completely full Drinking too much before bedtime Problems waking up from sleep (for example, being a very deep sleeper) Family history (if one parent had nighttime incontinence, there is a 30% chance offspring will have it, increasing to 70% if both parents had it) About 30% of cases are caused by an underlying medical disorder. Contributing factors include some of the disorders that cause daytime incontinence along with disorders that increase the amount of urine. Such disorders include Nephrogenic Diabetes Insipidus , Fordaytime incontinence,common causes include A bladder that is irritated because of a urinary tract infection or because something is pressing on it (such as a full rectum caused by constipation) An overactive bladder Urethrovaginal reflux (also called vaginal voiding), which can occur in girls who urinate in an incorrect position or who have extra skin folds, and can cause urine to back up into the vagina and then leak out when they stand up Anatomic abnormalities (often caused by birth defects, for example, a Misplaced ureters in girls or a congenital urinary tract obstruction) Weakness of the urinary sphincter, which controls the flow of urine out of the bladder (for example, because of a spinal cord abnormality) A bladder that does not empty completely ( Neurogenic Bladder ) because of a spinal cord or nervous system defect In both types of incontinence, stress, Attention-Deficit/Hyperactivity Disorder (ADHD) , or 