Why does the child not control urine (what to do)?

Urologist

The wet sheets and pyjamas of the child are typical scenes in many homes. For example, if your child has accidental or involuntary urine leaks and is past diaper age, he likely has a bladder control problem known as bedwetting or urinary incontinence. These urine losses can occur during the day (diurnal enuresis) or at night (nocturnal enuresis).

Childhood enuresis is the Repeated emission of urine in the bed or on the clothes, involuntarily or on purpose. The behaviour is clinically significant and manifests with a frequency of 2 times per week for three consecutive months. The chronological age from which it is considered a problem is five years for girls and six for boys or an equivalent level of development. These are approximate ages since organic maturity for sphincter control is around three years.

Most children achieve daytime control between the ages of two and three; the nocturnal can take considerably longer: one in ten does not reach it before six. According to some research, about 15 per cent of children over three wet the bed while sleeping and boys, more than girls, find themselves in this situation.

Bedwetting can have several causes that may be related to a sleep disorder, slower than usual development of bladder control, or the result of emotions and tensions that require special attention. For example, it rarely means the child has a kidney or bladder problem. Therefore, children do not wet the bed on purpose.

Types of bedwetting in children

There are four types of urination control problems : 

1. Primary enuresis is the accidental loss of urine by a child who has never managed to control the bladder regularly. 
2. Secondary enuresis is the accidental loss of urine by those children who, at some point, have been able to control their sphincters for at least six months but have now stopped doing so.
3. Diurnal enuresis: Urinary incontinence during the day.
4. Nocturnal enuresis: When children wet the bed at night while sleeping.

Some children may have both daytime and nighttime enuresis.

Causes of poor urine control in children

• Excessive fluid intake at night, before going to bed.
• The child has not yet learned to relate the filling of the urinary bladder with the need to urinate.
• The control of the sphincters begins at three, but it is expected that many children do not have strong muscles.
• Hereditary causes: If the parents also suffer from enuresis, the children are predisposed to suffer it.
• Altered sleep rhythms: If children don’t sleep well during the day, they often arrive at night tired, making it difficult for them to Wake up to urinate.
• Emotional causes: When a young child begins to wet the bed again after months or years of not doing so, it is suspected that new fears or insecurities may cause these symptoms. It can happen after the child witnesses changes in his life, for example, the family moving to a new environment, the loss of a family member or loved one, the arrival of a new baby, changing schools, stressful situations, etc.
• Physical illnesses: It is the least common factor, but some are diabetes, constipation, kidney disease or intestinal worms.

Enuresis may be related to some psychological and affective conflict of the child, with the child’s need to attract attention. It is also caused by exhaustion or emotional stress. Another possible cause may be in the family environment in which the child lives, in a family that overprotects him or offers little affection to their children. Some parents believe that if the child does not control the peeing, it is because he is lazy and does not pay more attention to the subject, and thus they apply punishments and provoke them with teasing, which will make the problem grow even more.

Treatment of childhood enuresis

Parents and caregivers should always treat bedwetting in children with patience, love, and a lot of understanding. Urine leakage is rarely due to a child’s strong will, and bladder control problems usually go away naturally as children age. If not, a doctor or health professional can review the causes and provide a proper diagnosis and treatment that sometimes, when it comes to emotional problems (the child is suffering from stress or anxiety), goes through psychological therapy.

The first specialist to visit will be the paediatrician, who will probably refer the child to the pediatric urologist to rule out the problem’s physiological causes. 

It is essential to consult with the doctor in the following cases:

Your child has symptoms of a urine infection which include:

• Pain or burning when urinating.
• Dark urine, cloudy blood and a terrible smell.
• Frequent urge to urinate, but you pee very little with each urination.
• Pain in the lower abdomen.
• Fever.
• Your child’s weak urine flow may be a symptom of a congenital disability in the urinary tract.
• Your son was already controlling his urine but has begun to have incontinence problems again.

Children’s stories to help children control urine

Children’s stories are an excellent resource to make children understand many things, including bedwetting. The most important thing is that, through the stories, the little ones can learn to have greater control over their urine and to take small steps to solve the problem. Below we offer you some stories that we have selected about childhood enuresis.