Overflow urinary incontinence

How does delaying urination put a young person at risk?

Infrequent voiders "...have learned to avoid using the toilet for long periods of time. They (may) go to the bathroom... only once or twice per day instead of four to seven times (which is usual for children)... they have learned to suppress the urge to go to the bathroom. Often they have been... discouraged from using the toilet by a caretaker (e.g. "You just went! You’ll have to hold it!"). Overtime, this... leads to gradual increase in the size of the bladder, but with a decreasing urge to urinate. Because their bladders have become gradually desensitized, these children may not feel the urge to go until it’s too late and they’ve already had an accident" (Suzanne Berman, M.D., 2002, Plateau Pediatrics).

"Normally, as our bladder fills it sends signals to the brain and we become aware that we will soon need to go to the bathroom. By ignoring these signals over a long period of time some bladders become stretched out and floppy. Children with bladders like this may not notice that they need to go to the bathroom until the bladder is so stretched that it just can’t hold any more urine. By then it may be too late for the child to get to the bathroom and they begin to leak urine" (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

"An infrequent or inefficient urinary voiding pattern is commonly associated with diurnal enuresis (daytime incontinence) and urinary infection, and likely represents a bad habit that is reinforced inadvertently by parents or other caretakers. Frequently, these children are described at being good at holding their urine, but will often exhibit urinary urgency and occasional diurnal enuresis. This delayed voiding behavior is akin to pressing the snooze alarm repeatedly on an alarm clock, and ultimately being late for school" (William R. Strand, M.D., Pediatric Urology Practice, 1999).

Medical advice for prevention of this urinary problem (click here)

Back To Top

Urinary tract infection (UTI)

How does delaying urination put a young person at risk?

"Infrequent voiding of urine may... lead to infection, allowing urine to pool longer and make conditions more likely to cause infection" (Children’s Hospital Medical Center of Akron, 2002).

"Poor toilet habits such as infrequent voiding or constipation are found in 90% of children who have had a UTI, but whose imaging studies are negative for anatomic abnormalities" (Wan and Greenfield, 1997, Pediatric Bulletin).

"Holding... urine in for long periods can allow germs to get into the bladder and start an infection. Urination helps prevent infection by flushing out the bladder" (The Detroit Medical Center Department of Urology, 2003).

"Infrequent voiders... are at risk for UTI’s because prolonged bladder incubation of urine compromises the protective effect of regular bladder washout, which clears bacteria..." (Hellerstein and Glasscock, 2002, eMedicine Journal).

"Urine collecting in a desensitized bladder which is incompletely or improperly emptied is an inviting place for bacteria to grow" (Suzanne Berman, M.D., 2002, Plateau Pediatrics).

"Retaining urine sets the stage for urinary tract infections" (National Kidney and Urologic Diseases Information Clearinghouse, 2002).

"Its very possible the child is not going to the bathroom often enough during the day... Parents should try to find out about their child’s bathroom habits during the school day... Infrequent urination can result in accidents during class, bed-wetting and frequent bladder infections" (William Strand, M.D., Parenthood.com).

"An infrequent or inefficient urinary voiding pattern is commonly associated with diurnal enuresis and urinary infection, and likely represents a bad habit that is reinforced inadvertently by parents or other caretakers" (William R. Strand, M.D., Pediatric Urology Practice, 1999).

Medical advice for prevention of this urinary problem (click here)

Back To Top

Overextension of the bladder muscle

How does delaying urination put a young person at risk?

"Infrequent voiders "...have learned to avoid using the toilet for long periods of time. They (may) go to the bathroom... only once or twice per day instead of four to seven times (which is usual for children)... they have learned to suppress the urge to go to the bathroom. Often they have been... discouraged from using the toilet by a caretaker (e.g. "You just went! You’ll have to hold it!"). Overtime, this... leads to gradual increase in the size of the bladder, but with a decreasing urge to urinate" (Suzanne Berman, M.D., 2002, Plateau Pediatrics).

"Some children do not void frequently enough and their bladders hold a larger than normal amount of urine. Normally, as our bladder fills it sends signals to the brain and we become aware that we will soon need to go to the bathroom. By ignoring these signals over a long period of time some bladders become stretched out and floppy. Children with bladders like this may not notice that they need to go to the bathroom until the bladder is so stretched that it just can’t hold any more urine." (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

"...Increasing bladder capacity (with infrequent voiding) can lead to bladder muscle failure, resulting in incomplete bladder emptying and straining to void" (Florida Urological Associates. (1999).

"Infrequent urination and incomplete emptying lead to an ever-increasing bladder size and capacity. This is turn leads to a decrease in sensation to empty the bladder... Renal failure may ultimately develop secondary to bladder function abnormalities" (MedHelp.org, Urology Forum).

"An infrequent or inefficient voiding pattern is initially associated with bladder capacities larger than would be predicted for age. However, increased bladder storage pressures resultant from this functional urinary tract obstruction ultimately leads to... bladder wall thickening and diminished storage capacity" (William R. Strand, M.D., Pediatric Urology Practice, 1999).

"Since the bladder may become overstretched in people who do not empty it very often, your child may say that he/she does not have to go as often as necessary" (The Detroit Medical Center Department of Urology, 2003).

Medical advice for prevention of this urinary problem (click here)

Back To Top

Weakening of the brain-bladder signals

How does delaying urination put a young person at risk?

"Infrequent urination and incomplete emptying lead to an ever-increasing bladder size and capacity. This is turn leads to a decrease in sensation to empty the bladder... Renal failure may ultimately develop secondary to bladder function abnormalities" (MedHelp.org, Urology Forum).

"Normally, as our bladder fills it sends signals to the brain and we become aware that we will soon need to go to the bathroom. By ignoring these signals over a long period of time some bladders become stretched out and floppy. Children with bladders like this may not notice that they need to go to the bathroom until the bladder is so stretched that it just can’t hold any more urine." (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

"Infrequent voiders "...have learned to avoid using the toilet for long periods of time. They (may) go to the bathroom... only once or twice per day instead of four to seven times (which is usual for children)... they have learned to suppress the urge to go to the bathroom. Often they have been... discouraged from using the toilet by a caretaker (e.g. "You just went! You’ll have to hold it!"). Overtime, this... leads to gradual increase in the size of the bladder, but with a decreasing urge to urinate" (Suzanne Berman, M.D., 2002, Plateau Pediatrics).

"Since the bladder may become overstretched in people who do not empty it very often, your child may say that he/she does not have to go as often as necessary" (The Detroit Medical Center Department of Urology, 2003).

Medical advice for prevention of this urinary problem (click here)

Back To Top

Incomplete voiding (Urinary frequency)

How does delaying urination put a young person at risk?

"Many things may cause a child to be unable to relax their sphincter muscles when trying to urinate. Once this pattern happens it becomes a vicious cycle...When a child urinates against a closed sphincter, a lot of pressure is generated in the bladder. Over time, the pressure can cause the bladder muscles to become very thick and the bladder may generate frequent, strong contractions. These contractions may cause the child to need to urinate frequently, and urgently... often the bladder does not empty completely which causes it to get to the full point more rapidly and creates frequent urination" (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

"Some children... urinate only until they get relief. When their bladders do not empty completely, they become stretched and desensitized, just as those children with infrequent voiding" (Suzanne Berman, M.D., Plateau Pediatrics, 2002).

"...Increasing bladder capacity (with infrequent voiding) can lead to bladder muscle failure, resulting in incomplete bladder emptying and straining to void" (Florida Urological Associates. (1999).

Medical advice for prevention of this urinary problem (click here)

Back To Top

Bladder contracting against closed sphincter (uncoordinated voiding)

How does delaying urination put a young person at risk?

"Sometimes a child with a hyperactive bladder will learn to ‘hold it’ when the bladder contracts, by tightening the sphincter muscles. These children may then develop uncoordinated voiding, when they do not relax the muscles during normal voiding. This can lead to incomplete emptying, predisposing the child to infections and possible kidney damage" (University Children’s Hospital, 2003)

"Some children’s bladder hold less than a normal amount of urine. In these children their bladder feels full even with small amounts of urine... Some... children try and delay urination by learning to contract down their sphincter muscles when the bladder feels full or contracts. Unfortunately, this can generate high pressures in the bladder which can damage the bladder or kidneys. It can also lead to urinating with a closed sphincter which is (one of three types of) voiding dysfunction" (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

"Many things may cause a child to be unable to relax their sphincter muscles when trying to urinate. Once this pattern happens it becomes a vicious cycle. Imagine squeezing down on a balloon while the fingers on the other hand squeeze the neck of the balloon shut- this generates a lot of pressure in the balloon. When a child urinates against a closed sphincter, a lot of pressure is generated in the bladder. Over time, the pressure can cause the bladder muscles to become very thick and the bladder may generate frequent, strong contractions... The high pressures in the bladder may force urine backwards up the tubes from the kidneys and damage the kidneys." (Christopher S. Cooper, M.D., 2000, Pediatric Urologist).

Medical advice for prevention of this urinary problem (click here)

Back To Top