Day Time Wetting

Voiding dysfunction program UCSF Pediatric Urology

UCSF pediatric urology has a dedicated program for addressing bladder and bowel dysfunction.  In this clinic we help manage the following issues: daytime urinary incontinence (enuresis), nighttime urinary incontinence (bedwetting), urinary urgency and frequency, urinary holding, recurrent urinary tract infections, constipation, and stool accidents.  This program consists of a multidisciplinary team including a pediatric urologist, a nurse practitioner, and a clinical nurse.  We use state-of-the-art technology and resources to diagnose and treat these conditions in children.  Anne Arnhym, NP is  medical director and overseas our continence clinic at the UCSF Mission Bay site in conjunction with Dr.  Hillary Copp.   Lucille Huang, NP overseas our Oakland Children’s site in conjunction with Dr. Michael DiSandro.  Both sites have state of the art facilities including urodynamics.  

Day-time wetting can be extremely frustrating and embarrassing for families and children. There are many reasons why children wet during the day ranging from something as simple as holding onto their urine too long to very rare physical causes.

Children generally do not wet out of laziness, emotional problems or inappropriate toilet training.

The different types of incontinence include:

• Very Common
  • Dysfunctional voiding: As the bladder empties, children with dysfunctional voiding tighten their pelvic floor muscles and may cut off the urine stream before completely emptying their bladder. They may leave a large amount of urine in their bladder.
  • Constipation (see separate page)
  • Underactive bladder: Children with underactive bladder tend to postpone voiding and only empty a few times a day with little urge to do so.
  • Vaginal voiding (peeing): Girls with vaginal voiding trap a small amount of urine in the vagina during voiding because their legs are too close together when they void. The urine dribbles out of the vagina at a later time after voiding is completed.
• Less Common
  • Overactive bladder: These children have uncontrolled bladder contractions that, in addition to incontinence, cause them to have frequent and urgent trips to the restroom.
• Rare
  • Giggle incontinence: Children with giggle incontinence wet ONLY when laughing. Once they start urinating they are unable to stop the flow of urine and usually soak their clothes.
  • Physical cause: Children are sometimes born with birth defects where tubes in the urinary tract go to the wrong place or children can have problems with the nerves that go to the bladder.

We have an entire program called “PUPS” devoted to the treatment and management of children who have day-time wetting for any of the above causes. Our team will work with you and your child to help understand why your child wets, and recommend a treatment plan.