children s health issues
Urinary Incontinence in Children
Introduction
Urinary incontinence is defined as the involuntary release of urine occurring two or more times per month after toilet training has been completed. Incontinence may be present During the day (daytime or diurnal incontinence) At night (nighttime incontinence, enuresis, or bed-wetting) Both (combined incontinence) The duration of the process of Toilet Training , or the age at which children achieve urinary continence, varies greatly. However, more than 90% of children achieve daytime urinary continence by age 5. Nighttime continence may take longer to achieve. Bed-wetting or nighttime incontinence affects about 30% of children at age 4, 10% at age 7, 3% at age 12, and 1% at age 18. About 0.5% of adults continue to have nighttime incontinence. Doctors take these timelines into account when diagnosing urinary incontinence. Because the duration of the process of toilet training varies, young children are usually not considered to have daytime incontinence if they are under age 5 or 6 or nighttime incontinence if they are under age 7. Daytime incontinence is more common among girls. Bed-wetting is more common among boys and among children who have a family history of it. Both daytime and nighttime incontinence are symptoms—not diagnoses—and doctors look for an underlying cause. A person's urination (voiding) pattern matures and transitions from the one that occurs during infancy to the one that occurs during adulthood. In the infant pattern, bladder contractions occur by reflex, and the urine is not stopped by contraction of the urinary sphincter (muscles around the tube that drains urine from the bladder). In the adult pattern, bladder contractions are suppressed by signals from the brain. 