Bedwetting and urinary urgency

Urinary urgency is extremely common in children of all ages. This problem usually becomes very obvious to others when a child squirms, squats, wiggles, and demands quick access to the bathroom.

In the past, parents were encouraged to tell their children to hold in the urine and avoid frequent use of the restroom. It was thought that this would stretch the bladder, and would give them more time before needing to use the restroom. Recently, pediatric urologists have discouraged the practice of having children try to avoid using the restroom. Having a child postpone using the restroom forces them to tighten their pelvic muscles, thereby strengthening these muscles. Then, when the child wants to go to the bathroom, he is less likely to be able to relax the strengthened pelvic muscles and let all of the urine out. It is very important to constantly remind your child to use the restroom. Children should use the restroom at least every two hours.

The medications that relax the bladder and avoid spasms in adults can also be used in children with urinary urgency. These medications may give the child more of a gradual warning prior to the sudden urge to urinate. These medications are also commonly used in adults with urinary incontinence and frequency. The most commonly used drugs are oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), and hyoscyamine (Levsin). The problem of holding the urine until the last moment, and the thickening of the bladder will not be corrected with these medications alone. Only restructuring the child’s daily potty habits will correct the root of the problem.
 

- Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith's dedication to helping children with urologic problems inspired him to establish PottyMD.