Childhood and Adolescent Incontinence

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Urinary incontinence affects up to 10% children and teenagers under the age of 18 years old and like the many adults who experience incontinence, children and teenagers in particular may avoid discussing the topic due to embarrassment or not knowing who to talk to. Urinary or faecal incontinence can greatly impact the quality of life of children and teenagers.

 

Our adolescent years are when we start to establish our independence, find our friendship groups, play sports, and get our first job. Trying to manage incontinence in combination with these things can be a tricky task. Similarly, childhood incontinence can interrupt a child’s daily routine, schooling, social development, physical activity and sleep. 

The majority of childhood incontinence improves with age and responds well to bladder and bowel retraining. Understanding what normal bladder habits are is the first step in treating incontinence.

 

How many times should I empty my bladder each day?

Emptying your bladder between 4 and 6 times per day and once overnight is normal. If a child or teenager is going to the toilet more frequently, this may suggest overactive bladder. If they are 3 times or less per day, the child may be holding on and may experience increased urgency due to larger bladder volumes. 

 

How big or small should a wee be?

Our bladders can hold between 400 and 600 millilitres of fluid however children between the ages of 4 and 12 years old have smaller bladders so it is normal for them to have smaller wees. 

 

Common Conditions 

Overactive Bladder 

  • Children or teens with overactive bladder will often empty their bladder more frequently than normal and may experience urgency when needing to go to the toilet.
  • The volume of fluid per void also may be smaller than expected. 
  • It is the most common cause of urinary incontinence in children.

Giggle Incontinence

  • True giggle incontinence is the complete emptying of the bladder associated with laughing.
  • Leakage with laughing is usually related to overactive bladder or void postponement (holding on too long) and is more common in girls than boys.

 

How is childhood and adolescent incontinence treated?

Completing a Bladder Diary 

  • Getting an understanding of how the person’s bladder habits compare to normal is the best place to start. 
  • A bladder diary is used to record the frequency of urination, volume of fluid, level of urgency as well as any episodes of leakage. 
  • A bladder diary also includes fluid intake volume and type. 
  • This information can help determine what is contributing to the child’s symptoms and assist in developing a treatment program.

Bladder and Bowel Retraining

  • Aims to improve the child or adolescents function and control of urination and defaecation. 
  • This may involve timed voids and urgency management strategies.

Pelvic Floor Muscle Training

  • The pelvic floor muscles contract to let us to hold on and relax to allow us to empty our bladder and bowel.
  • Some incontinence is due to poor strength or control of these muscles so through a specific training program the muscle can become more functional.

Lifestyle Factors

  • Children and teenagers should be participating in 60 minutes or more of moderate to vigorous physical activity per day. Physical activity is important for maintaining physical, social and mental health.
  • Having a balanced diet with sufficient fibre and drinking enough water is crucial for the management of incontinence. 
  • Diet, hydration and physical activity are all important to help prevent constipation and manage body weight which can also play a role in continence.

 

If your child is suffering from childhood or adolescent incontinence, book an appointment with one of our Physiotherapists today, click here to book.

 

References and further reading:

Continence Foundation of Australia. https://www.continence.org.au/

Incontinence in Confidence Adolescent Support. https://www.inconfidence.org.au/ 

NSW Government & Agency for Clinical Innovation. (2018) Young people with urinary incontinence

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