Incontinence

The Norton Children’s Urology staff physicians in Louisville are fellowship trained in pediatric and adolescent urology specialty care. They have the expertise to treat incontinence daytime and nighttime wetting).

We have state-of-the-art equipment that is unavailable elsewhere in Louisville and Southern Indiana. Our specialists bring skill, respect and sensitivity to caring for your child’s urological needs.

Enuresis or nocturnal enuresis refers to incontinence in kids who are old enough to have developed bladder control.

Enuresis can occur during the day or at night. Most kids can control their bladders (with occasional accidents) by age 4 during the day and by age 6 overnight.

Enuresis (Daytime Wetting)

Enuresis means your child is not properly or not completely emptying their bladder. It can be used to describe various voiding dysfunction problems, such as daytime wetting, urine leakage or the frequent urge to use the bathroom. The condition is common and can range from mild to severe.

Enuresis can be embarrassing for children. It’s often frustrating for parents too. Our team will work with families to identify the cause and resolve the problem.

Causes

Enuresis often is a learned problem. In some cases, children may avoid using the bathroom because they don’t want to stop playing. Others may have once had a urinary tract infection that made it painful to urinate, and now they’re afraid. A child who had a difficult time potty-training might have poor bathroom habits. .

Other potential causes include:

  • Stress incontinence (urine leakage when coughing or sneezing)
  • Giggle incontinence (urine leakage when laughing)
  • Urinary tract problems that developed before birth
  • Infections
  • Central nervous system, endocrine or kidney conditions
  • Genetic diseases that affect the urinary tract

Signs and Symptoms

Daytime wetting may be the first sign of enuresis. When a child over age 4 has frequent daytime accidents with no obvious underlying medical cause, he or she may be diagnosed with enuresis.

Other symptoms include:

  • Frequent or infrequent urination
  • Urgent need to urinate without a full bladder
  • Feeling like the bladder is full when it’s not
  • Pain or straining with urination
  • Hesitancy to urinate
  • Leaking small amounts of urine
  • Urinary tract infections

Enuresis Diagnosis

Our team works with families to evaluate your child. This often begins with detailed questions about your child’s bathroom habits and frequency of accidents. A physical exam will be performed. Tests such as an ultrasound or X-ray may be necessary to rule out underlying medical causes. Urine might be checked for signs of infection.

Enuresis Treatments

The treatment for enuresis depends on the type and cause, as well as your child’s age.

In some cases, we may recommend your child use the bathroom on a timed schedule. Other measures, such as avoiding caffeine and treating constipation, might also be suggested.

If your child has frequent urinary tract infections, we will address that issue first.

If your child has difficulty emptying their bladder, we may recommend urinating twice in a row to empty their bladder more completely.

In some children, medication may be necessary to normalize bladder activity.

Nocturnal enuresis (Bedwetting)

There is no single cause for nocturnal enuresis, but certain factors, such as bladder capacity and genetics, may play a role.

Possible causes include:

  • Small or underdeveloped bladder
  • Overactive bladder, resulting in a sudden urge to urinate
  • Underactive bladder, resulting in the inability to fully empty the bladder
  • Constipation
  • Urinary tract infection
  • Stressful life events or general anxiety
  • Deep sleep
  • Poor bathroom habits (like being too busy playing to use the bathroom)

Nocturnal Enuresis Treatment and Diagnosis

Enuresis usually isn’t diagnosed in a child until at least age 5, but that depends on the severity of the problem.

Our team of providers will work with you to better understand why your child wets and recommend a treatment plan. We will assess your child’s medical history and conduct a physical exam. In more complex cases, we may perform diagnostic tests to look for an underlying medical condition. Such tests include:

  • Urinalysis
  • X-ray of the pelvis and abdomen
  • Ultrasound

Possible treatments for enuresis include:

  • Urinating on a schedule during the day.
  • Using an alarm at night to wake your child for a bathroom break.
  • Treating any underlying conditions (like constipation or urinary tract infection).
  • Behavior modification.
  • Biofeedback training, which teaches children how to relax pelvic muscles so they can empty their bladder.
  • Medications (for children with an overactive bladder).
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