Approximately 90% of children achieve urinary continence by the age of 5, but what is it like for those 10% that are “accident-prone”? Day- or night-wetting for children is not only uncomfortable but can also limit participation in sports, sleepovers and other social activities; and although less than 1% of affected children continue to experience incontinence into adulthood, it is crucial to identify and treat the cause of it sooner rather than later.
There are two types of paediatric incontinence: nocturnal (night or bedwetting) and diurnal (day wetting). Children can experience either one or both types of leakage. Many factors can contribute to ongoing urinary incontinence, including:
voiding dysfunction or deferral
urinary tract infection
pelvic floor weakness
distraction/avoidance
uncompleted toilet training
unnatural voiding positions (e.g. legs close together)
family history
Very commonly, urinary incontinence is associated with constipation that may or may not be diagnosed. In many children, treating constipation first may relieve signs of accidental wetting and allow them to regain control over their bladder.
If your child is over 5 and still having trouble holding in their urine, it is important to have them assessed by a paediatric or pelvic health physiotherapist.
What to expect from your child’s first appointment?
Unlike adult pelvic health exams, there is no internal component for the child. Instead, the physiotherapist will take a detailed history from the parents and child to determine the root cause of the problem and offer suggestions for behaviour modification as well as exercises to treat the incontinence.
References:
Figueroa, T. Urinary incontinence in children. Merck Manual. Jan. 2018.
Nankivel, G., Caldwell, P. Paediatric urinary incontinence. Australian Prescriber. Dec. 2014; 37(6):192-195
Sandra Ghaly, Pelvic Floor & Paediatric Physiotherapist
Sandra graduated from Dalhousie University with a Masters degree in Physiotherapy after completing her Bachelor of Kinesiology degree with honours from McMaster University. She has worked with a variety of clientele but has developed a true passion in working with both the paediatric and women’s health populations. Sandra has extensive experience assessing and treating a variety of paediatric conditions and most recently has become certified as a pelvic health physiotherapist. She also has additional training in acupuncture and kinesiotaping. Sandra finds great value in guiding each individual through a tailored rehabilitation program to optimize their function and quality of life. In her free time, Sandra enjoys yoga, pilates, traveling and spending time with family and friends.
If you have enjoyed this blog and would like to learn more about health and wellness from our team of expert practitioners, follow us on Facebook and Instagram.