Skip to main content
SpringerLink
Log in

Daytime Urinary Incontinence

  • Living reference work entry
  • First Online:
Pediatric Surgery

  • 22 Accesses

Abstract

Daytime urinary incontinence in childhood is functional in the vast majority of cases and when combined with urgency symptoms suggests detrusor overactivity as the underlying pathogenetic mechanism. Warning signs that signal a risk for serious underlying conditions are continuous, dribbling incontinence or voiding difficulties with poor urinary stream and a need to strain to void. In these cases, further urodynamic and/or radiologic examination is warranted. A urinary tract infection may cause urge incontinence, but if the complaint is not new and there is no dysuria, the finding of a positive urine culture is more likely due to contamination or asymptomatic bacteriuria. Constipation is very common among incontinent children and needs to be successfully treated before the incontinence can be managed. Likewise, some of these children have neuropsychiatric or behavioral issues that may make adherence to therapy hard to achieve. Most incontinent children do not need extensive or invasive evaluation; a thorough case history, a physical examination, and the completion of a bladder diary are usually sufficient. Uroflowmetry and assessment of residual urine is needed if there are recurrent urinary tract infections or a suspicion of voiding difficulties. First-line therapy is basic urotherapy, in particular the establishment of regular voiding habits, for many weeks (follow-up visits needed). If this is not successful and there is no constipation or residual urine, then anticholinergic medication should be added. Incontinence in childhood is both a cause for decreased self-esteem and a risk factor for incontinence or other bladder problems in adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Allen HA, Austin JC, Boyt MA, Hawtrey CE, Cooper CS. Initial trial of timed voiding is warranted for all children with daytime incontinence. Urology. 2007;69(5):962–5.

    Article  PubMed  Google Scholar 

  • Anger JT, Weinberg A, Suttorp MJ, Litwin MS, Shekelle PG. Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: a systematic review of the literature. J Urol. 2010;183(6):2258–64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Austin P, Bauer S, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the international Children’s continence society. J Urol. 2014;191(6):1863–5.

    Article  PubMed  Google Scholar 

  • Bakker E, van Sprundel M, van der Auwera JC, van Gool JD, Wyndaele JJ. Voiding habits and wetting in a population of 4,332 Belgian schoolchildren aged between 10 and 14 years. Scand J Urol Nephrol. 2002;36(5):354–62.

    Article  CAS  PubMed  Google Scholar 

  • Bolduc S, Upadhyay J, Payton J, Bagli DJ, McLorie GA, Khoury AE, et al. The use of tolterodine in children after oxybutynin failure. BJU Int. 2003;91(4):398–401.

    Article  CAS  PubMed  Google Scholar 

  • Bolduc S, Moore K, Nadeau G, Lebel S, Lamontagne P, Hamel M. Prospective open label study of solifenacin for overactive bladder in children. J Urol. 2010;184:1668–73.

    Article  PubMed  Google Scholar 

  • Bower WF, Yeung CK. A review of non-invasive electro neuromodulation as an intervention for non-neurogenic bladder dysfunction in children. Neurourol Urodyn. 2004;23(1):63–7.

    Article  CAS  PubMed  Google Scholar 

  • Bower WF, Moore KH, Shepherd RB, Adams RD. The epidemiology of childhood enuresis in Australia. Br J Urol. 1996;78(4):602–6.

    Article  CAS  PubMed  Google Scholar 

  • Burgers R, de Jong TP, Visser M, Di Lorenzo C, Dijkgraaf MG, Benninga M. Functional defecation disorders among children with lower urinary tract symptoms. J Urol. 2012;189(5):1886–91.

    Article  PubMed  Google Scholar 

  • Burgers RE, Mugie SM, Chase J, Cooper CS, von Gontard A, Rittig CS, et al. Management of functional constipation in children with lower urinary tract symptoms; report from the standardization Committee of the International Children's continence society. J Urol. 2013;190(1):29–36.

    Article  PubMed  Google Scholar 

  • Cain MP, Wu SD, Austin PF, Herndon CD, Rink RC. Alpha blocker therapy for children with dysfunctional voiding and urinary retention. J Urol. 2003;170(4 Pt 2):1514–5.

    Article  CAS  PubMed  Google Scholar 

  • Chang JH, Lee KY, Kim TB, Yoon SJ, Lee T, Kim KH. Clinical and urodynamic effect of methylphenidate for the treatment of giggle incontinence (enuresis risoria). Neurourol Urodyn. 2011;30(7):1338–42.

    CAS  PubMed  Google Scholar 

  • Fitzgerald MP, Thom DH, Wassel-Fyr C, Subak L, Brubaker L, Van Den Eeden SK, et al. Childhood urinary symptoms predict adult overactive bladder symptoms. J Urol. 2006;175(3 Pt 1):989–93.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gladh G, Mattsson S, Lindström S. Outcome of the bladder cooling test in children with nonneurogenic bladder problems. J Urol. 2004;172(3):1095–8.

    Article  PubMed  Google Scholar 

  • Hägglöf B, Andrén O, Bergström E, Marklund L, Wendelius M. Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scand J Urol Nephrol. 1997;31(Suppl 183):79–82.

    Google Scholar 

  • Hagstroem S, Rittig N, Kamperis K, Mikkelsen MM, Rittig S, Djurhuus JC. Treatment outcome of day-time urinary incontinence in children. Scand J Urol Nephrol. 2008;30(Apr):1–6.

    Google Scholar 

  • Hagstroem S, Mahler B, Madsen B, Djurhuus JC, Rittig S. Transcutaneous electrical nerve stimulation for refractory daytime urinary urge incontinence. J Urol. 2009;182:2072–8.

    Article  PubMed  Google Scholar 

  • Hagstroem S, Rittig S, Kamperis K, Djurhuus JC. Timer watch assisted urotherapy in children. A randomised controlled trial. J Urol. 2010;184(4):1482–8.

    Article  PubMed  Google Scholar 

  • Hansson S, Hjälmås K, Jodal U, Sixt R. Lower urinary tract dysfunction in girls with untreated asymptomatic or covert bacteriuria. J Urol. 1990;143:333–5.

    Article  CAS  PubMed  Google Scholar 

  • Hansson S, Martinell J, Stokland E, Jodal U. The natural history of bacteriuria in childhood. Inf Dis Clin North Am. 1997;11(3):499–512.

    Article  CAS  Google Scholar 

  • Hoebeke P, Bower W, Combs A, de Jong TP, Yang S. Diagnostic evaluation of children with daytime incontinence. J Urol. 2010;183:693–703.

    Google Scholar 

  • Hoebeke P, Renson C, De Schryver M, De Schrijver L, Leenaerts E, Schoenaers A, et al. Prospective evaluation of clinical voiding reeducation or voiding school for lower urinary tract conditions in children. J Urol. 2011;186(2):648–54.

    Article  CAS  PubMed  Google Scholar 

  • Joensson IM, Siggaard C, Rittig S, Hagstroem S, Djurhuus JC. Transabdominal ultrasound of rectum as a diagnostic tool in childhood constipation. J Urol. 2008;179(5):1997–2002.

    Article  PubMed  Google Scholar 

  • Joinson C, Heron J, von Gontard A. Psychological problems in children with daytime wetting. Pediatrics. 2006;118(5):1985–93.

    Article  PubMed  Google Scholar 

  • Kajiwara M, Inoue K, Usui A, Kurihara M, Usui T. The micturition habits and prevalence of daytime urinary incontinence in Japanese primary school children. J Urol. 2004;171:403–7.

    Article  PubMed  Google Scholar 

  • Kim JH, Lee JH, Jung AY, Lee JW. The prevalence and therapeutic effect of constipation in pediatric overactive bladder. Int Neurourol J. 2011;15(4):206–10.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuh D, Cardozo L, Hardy R. Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J Epidemiol Community Health. 1999;53(8):453–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Linde JM, Ekelmans-Hogenkamp JLA, Hofmeester I, Kroes-van Hattem G, Steffens MG, Kloosterman-Eijgenraam FJ, Nijman RJM, Blanker MH. Parents' expectations of the outpatient care for daytime urinary incontinence in children: a qualitative study. J Pediatr Urol. 2021;17(4):473.e1–7.

    Article  Google Scholar 

  • Mattsson S, Gladh G. Urethrovaginal reflux--a common cause of daytime incontinence in girls. Pediatrics. 2003;111(1):136–9.

    Article  PubMed  Google Scholar 

  • McLennan MT, Melick C, Bent AE. Urethral instability: clinical and urodynamic characteristics. Neurourol Urodyn. 2001;20:653–60.

    Article  CAS  PubMed  Google Scholar 

  • Moore KH, Ray FR, Barden JA. Loss of purinergic P2X3 and P2X5 receptor innervation in human detrusor from adults with urge incontinence. J Neurosci. 2001;21(RC166):1–6.

    Google Scholar 

  • Nevéus T, Fonseca E, Franco I, Kawauchi A, Kovacevic L, Nieuwhof-Leppink A, Raes A, Tekgül S, Yang SS, Rittig S. Management and treatment of nocturnal enuresis-an updated standardization document from the International Children's Continence Society. J Pediatr Urol. 2020;16(1):10–9.

    Article  PubMed  Google Scholar 

  • Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc Health. 2019;3(7):492–501.

    Article  PubMed  Google Scholar 

  • Nijman RJ. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children. J Urol. 2004;63(3 suppl 1):45–50.

    Article  Google Scholar 

  • Richardson I, Palmer LS. Successful treatment for giggle incontinence with biofeedback. J Urol. 2009;182:2062–6.

    Article  PubMed  Google Scholar 

  • San ST, Barnes EH, Caldwell PHY. Urinary incontinence during laughter in children: Is it giggle incontinence? J Paediatr Child Health. 2021;57(12):1971–5.

    Article  PubMed  Google Scholar 

  • Sillén U, Arwidsson C, Doroszkiewicz M, Antonsson H, Jansson I, Stålklint M, et al. Effects of transcutaneous neuromodulation (TENS) on overactive bladder symptoms in children: a randomized controlled trial. J Pediatr Urol. 2014;10(6):1100–5.

    Article  PubMed  Google Scholar 

  • Sreedhar B, Yeung CK, Leung VYF, Chu CW. Ultrasound bladder measurements in children with severe primary nocturnal enuresis: pretreatment and posttreatment evaluation and its correlation with treatment outcome. J Urol. 2008;179:1568–72.

    Article  CAS  PubMed  Google Scholar 

  • Sureshkumar P, Craig JC, Roy LP, Knight JF. Daytime urinary incontinence in primary school children: a population-based survey. J Pediatr. 2000;137:814–8.

    Article  CAS  PubMed  Google Scholar 

  • Toktamis A, Demirel Y, Ozkan KU, Garipardic M, Gözükücük A, Nur N. Prevalence and associated factors of day wetting and combined day and night wetting. Urol Int. 2008;81(1):54–9.

    Article  PubMed  Google Scholar 

  • Ural Z, Ulman I, Avanoglu A. Bladder dynamics and vesicoureteral reflux: factors associated with idiopathic lower urinary tract dysfunction in children. J Urol. 2008;179:1564–7.

    Article  PubMed  Google Scholar 

  • Van Arendonk KJ, Austin JC, Boyt MA, Cooper CS. Frequency of wetting is predictive of response to anticholinergic treatment in children with overactive bladder. Urology. 2006;67(5):1049–54.

    Article  PubMed  Google Scholar 

  • Van Laecke E. Elimination disorders in people with intellectual disability. J Intellect Disabil Res. 2008;52(10):–810.

    Google Scholar 

  • Vijverberg MA, Stortelder E, de Kort LM, Kok ET, de Jong TP. Long-term follow-up of incontinence and urge complaints after intensive urotherapy in childhood (75 patients followed up for 16.2-21.8 years). Urology. 2011;78(6):1391–6.

    Article  PubMed  Google Scholar 

  • von Gontard A, Baeyens D, Van Hoecke E, Warzak WJ, Bachmann C. Psychological and psychiatric issues in urinary and fecal incontinence. J Urol. 2011a;185(6):2303–7.

    Article  Google Scholar 

  • von Gontard A, Heron J, Joinson C. Family history of nocturnal enuresis and urinary incontinence: results from a large epidemiological study. J Urol. 2011b;185(6):2303–6.

    Article  Google Scholar 

  • Wu T, Duan X, Cao CX, Peng CD, Bu SY, Wang KJ. The role of mirabegron in overactive bladder: a systematic review and meta-analysis. Urol Int. 2014;93(3):327–37.

    Article  CAS  Google Scholar 

  • Yokoyama T, Nozaki K, Fujita O, Nose H, Inoue M, Kumon H. Role of C afferent fibers and monitoring of intravesical resiniferatoxin therapy for patients with idiopathic detrusor overactivity. J Urol. 2004;172(2):596–600.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Nephrology Unit, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Tryggve Nevéus

Authors
  1. Tryggve Nevéus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tryggve Nevéus .

Editor information

Editors and Affiliations

  1. Beacon Hospital, University College Dublin, Dublin, Ireland

    Prem Puri

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer-Verlag GmbH Germany, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Nevéus, T. (2022). Daytime Urinary Incontinence. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_202-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38482-0_202-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation