Primer: Diagnosis and Management of Uncomplicated Daytime Wetting in Children

Vijaya M Vemulakonda; Eric A Jones

Disclosures

Nat Clin Pract Urol. 2006;3(10):551-559. 

In This Article

Summary and Introduction

Functional daytime wetting is a common source of pediatric urologic complaints. Evaluation typically begins in the office setting. In contrast to the adult population, where an inability to maintain voiding control is virtually always considered pathologic, the evaluation of urinary incontinence in children must occur within the context of the child's developmental age. Functional incontinence refers to cases of urinary incontinence in which no structural or neurologic abnormality can be identified. The underlying etiologic mechanisms are heterogeneous, and include disorders of both the storage and voiding phases of the bladder cycle. Optimal treatment of functional daytime wetting depends on an accurate determination of the underlying etiology. Therapeutic options include behavior modification, medication, and aggressive treatment of comorbid conditions such as urinary infection and constipation.

Daytime wetting is one of the most common urologic complaints in children. Wetting is often considered a minor annoyance, which is generally outgrown as the child matures. Parents often do not recognize daytime wetting as a problem until it has developed into a clinically significant pattern, and treatment of these patients is often difficult. One reason why daytime wetting is difficult to treat is that it can result from a wide spectrum of bladder storage and voiding disorders. As a result, physicians must understand the range of voiding disorders, as well as be familiar with the available diagnostic and management tools, if they are to address the problem of daytime wetting adequately. This article discusses the common etiologies of functional daytime wetting, outlines a simple diagnostic algorithm, and covers the available treatment options.

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