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Children are not small adults. They have their own set of
problems with bodily systems. Urinary incontinence is the
loss of bladder control that results in involuntary urine
leakage or the inability to empty the bladder at will. That
simply means that children old enough to control their
bladders cannot do so consistently. Voiding dysfunction is
the term health care professionals use when a child does not
empty his or her bladder normally.
Incontinence affects many children at some time or
another, but it usually disappears naturally over time. Many
children experience nighttime "bed wetting" as a natural
part of growing up. This type of incontinence generally goes
away as the child matures.
For other children, incontinence or voiding dysfunction
may be more troublesome. According to Christopher Cooper,
M.D., UI Health Care pediatric urologist, "school-age
daytime incontinence occurs in 5 to 15 percent of children.
"Half of a child's waking hours are spent at school, and
that suggests a significant impact on learned toileting
behaviors." A recent study conducted by Cooper shows that
many children experience less than optimal conditions in
public elementary school to reinforce good bathroom habits.
"And these conditions get significantly worse following
kindergarten.
"Teachers have the potential to make a significant impact
on children with dysfunctional voiding problems, but they
are infrequently and poorly informed regarding these issues.
Teachers could play a pivotal role in preventing,
identifying and helping children with dysfunctional
voiding," he says.
What works
The treatment for dysfunctional voiding depends on the
type and cause of the problem, as well as the child's age
and ability. A child should never be punished for wetting
since this is something that is not under his control. It is
better to reward the child for voiding which is under her
control.
For children:
- With a small capacity bladder, an
"anticholinergic" medication may increase bladder
capacity and decrease bladder contractions in patients
whose bladder contracts too frequently. It is important
that these children go to the bathroom frequently. Trying
to "hold on" can damage the bladder and kidneys and teach
the child improper voiding.
- With a large bladder, (children who do not
void often), the best treatment is frequent trips to the
bathroom (about every two hours). Since larger bladders
may be stretched out and not empty well, it is important
for many of these children to spend several minutes
trying to make sure the bladder is completely empty. By
frequently and completely emptying the bladder, the child
reduces the chance of wetting or infections and starts to
recognize the early signals from the bladder telling the
brain that it's time to urinate.
What is a pediatric urologist?
If your child has an illness or disease of the urinary
tract or genitals, a pediatric urologist has the expertise
and qualifications to treat your child.
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For more information:
Listed above are several Web sites that offer additional
information on this topic. University of Iowa Health Care
does not sponsor or endorse these sites, or guarantee the
accuracy of the information contained on these sites. These
links are here for general information only, and should not
be used for personal diagnosis or treatment. If you have any
questions, please contact UI
Health Access.
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