Daytime urinary incontinence in children and adolescents.

Daytime urinary incontinence is common in the paediatric population and affects approximately 7-10% of children (aged 5-13 years). Several subtypes of daytime incontinence, which are classified according to their relation to the storage and voiding phases of bladder function, exist. Risk factors for these subtypes of incontinence can be genetic, demographic, environmental, behavioural, or physical. Therefore, treatment is multidisciplinary and needs an adequate diagnosis to be successful. Urotherapy is the first-line treatment for all types of daytime incontinence. It can be defined as bladder re-education or rehabilitation, aiming at correcting the filling and voiding function of the bladder-sphincter unit. Comorbid problems, such as constipation, urinary tract infections, and behavioural problems should also be treated during urotherapy. For comorbidities and severe bladder overactivity, medication might be necessary. Although usually effective, treatment of daytime urinary incontinence in children is often complex and requires patience. Nonetheless, patients and parents are usually motivated for urotherapy, since quality of life is severely reduced in in children with incontinence.

The Lancet. Child & adolescent health. 2019 May 03 [Epub ahead of print]

Anka J Nieuwhof-Leppink, Rogier P J Schroeder, Elise M van de Putte, Tom P V M de Jong, Renske Schappin

Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: ., Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands., Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands., Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands; Department of Pediatric Urology, University Children's Hospital, University Medical Center Amsterdam, Amsterdam, Netherlands., Department of Medical Psychology and Social Work, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.

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